Does nursing school teach you how to react to a dead/dying patient?

akulahawkRN, ADN, RN, EMT-P · Mar 1, 2014

In my experience so far, the answer is basically a "not exactly". Nursing School won't teach you exactly how to react to a dead/dying patient. Along the way, though, you'll learn how you react to various situations, and one of them may be a patient that is in decline or that may have died. You'll learn what's usually appropriate and will learn some therapeutic communication techniques for situations like the one you describe.

In these situations, the family is often as much "the" patient as the patient is. Don't neglect them and their needs, but you won't be charting all the time about them as a separate patient.

Palliative Care, DNP · Mar 1, 2014

Nothing teaches you how to deal with death and dying until you experience it. Being in oncology I have had the privilege of being there for some of the bravest people I have ever had the honor of meeting. Is it sad? Yes, but I feel comforted being able to provide some measure of dignity and peace in their hour of need.

NOADLS · Mar 1, 2014

Not a very stressful situation IMO. Good communication with the family and realize your boundaries and responsibilities in the nurse-patient relationship and it's fairly ABC.

tokebi · Mar 1, 2014

All nursing curriculum includes topics on death and dying. So, I'm sure you will have ample opportunity to discuss your concerns. A good instructor will also teach you the appropriate way a nurse should approach post-mortem care and handling grieving family members. Don't worry too much about it. Even if you feel awkward at first, you will become comfortable with experience.

RainbowHead · Mar 1, 2014

Thank you so much for the polite comments! I'm very grateful to have found this site and I appreciate your answers and support.

Bortaz, MSN, RN · Mar 1, 2014

In my opinion, nursing school doesn't prepare you for being a nurse, period. Especially this type of encounter. Most of us learned by doing.

I work in NICU. I had 2 students following me a day or 2 ago. Coincidentally, we had a baby that had expired an hour or so before the students arrived. I had them observe post-mortem care being done, and they went with me to the morgue when I took the angel down. By their own admission, it was an eye opening day for them...one of which was leaning towards NICU...now she's not. I felt it was a very valuable clinical day for the students.

Mr. Murse · Mar 1, 2014

It's one of those things that you can't learn in a text book. I mean yes, you can learn post-mortem care (cleaning the body, tagging, etc) but you can never be taught how to emotionally, psychologically, and spiritually handle death.

My only advice is to just be aware and conscientious of it. One day, you will most likely have a patient die (depending on where you end up working), it happens. Expect it.

The hardest part, in my opinion, is dealing with the family. They are the ones whose reactions will really affect you most. I remember my very first day of clinical, having never worked in a hospital before, I had an 80 something year old patient who the nurse told me at report "could go any time now". While the patient was completely unconscious, the daughter was at the bedside weeping the whole day as I fumbled through my first few hours in the medical field. Fortunately, she did not pass on my shift, but it showed me that the family can sometimes require more care than the patient.

That's the other reason text books could never tell you how to handle deaths: every one will be different. Sometimes the patient will be DNR, asleep and alone in the room, you may go in to check something and find them already gone without any sound or warning. Other times there will be family in the room who freak out when they realize their loved one has passed. Other times you'll have a full code patient fighting for life and losing.

So to summarize, no, you can't fully prepare because you don't know what situation you're preparing for.

K+MgSO4, BSN · Mar 1, 2014

Ahh my first day of clinical placement as a 17 year old. Walk onto the ward discover that my preceptor is sick and I have been allocated to nurse X. The ward manger apolgises to me. I have no idea why..........cue handover full of accromyms that I don't understand. Nurse x and I head off the the end of the ward, she sighs and tells me she doesn't work with students. She then proceeds to tell me that the first task she has is to get a body prepared for the mourge. I think, ok I can hadle this, I grew up in rural Ireland, death is not new to me. She and a HCA go into the room with me following. Pt is obviuosly dead. However he is still upright in bed, air matress on and oxygen still running.

What I proceeded to witness was one of the most horrifying sceens I have ever seen. The nurse and HCA flattened the bed and then "straightened" this pt. Basically they both leaned on a shoulder and pushed him down untill he was horizontal. I was standing in the corner unable to move. If I could I think I would of quit that day. However I couldn't move and swore that I would ever leave a dead pt like that to have anyone else witness what I saw that day nor for any pt have to think that is whag happens to their body after they die.

12 years later (4+8) my staff think I am insane as the first thing I do if they have had a pt die is check that they are flat in the bed.

mindlor · Mar 1, 2014

Usually when a pt dies, and I have a lot of them I am happy!!! HAPPY HAPPY because typically they were suffering big time. I am thrilled that they are free now and no longer shackled to a negative quality of life existence. Keeping people alive who have a tiny chance of having any quality of life is not going to be sustainable in the near future....

Change is coming

HappyWife77, BSN, RN · Mar 1, 2014

I hate losing patients....that aren't on their deathbed.

It never gets easy...it just doesn't.

For me, knowing Elizabeth Kubler-Ross's (there are others but hers are closest to what I've encountered) five stages of death and knowing that at anytime patients and or their family members are going thru the stages...in no particular order and sometimes revisiting them has helped me understand and determine the support I try to provide at any given time during the process.

Thank God it usually comes naturally!

Denial, bargaining, anger, depression and acceptance are the stages it seems people go thru. Allowing space yet letting them know you are available is key. Besides the facilty or company protocol...you should clean the body, dress them in something that you have there that looks clean and comfortable. Straighten out the bed, fold their hands together...or keep under the blankets( depending if theyre badly bruised from IV's and what not) , provide chairs next to the bed if possible for family to sit and grieve and be by their loved one....while waiting for funeral home to come get the body.

Working4ALiving · Mar 1, 2014

I had to laugh at this remember last year when my father died after a battle with terminal cancer. I had the privilege of being with my father last year when he died, and soon after my sister-in-law (who had more experience than I as a nurse...I was in my last class in nursing school) was flattening him down in the bed, making sure that he doesn't go into rigor mortis in an odd position because it's hard for the morticians to flatten these people out!

ETA: this is response to K+MgMSO4's post