RN Pronouncement

[CoffeeRTC, BSN, RN]

Called to room by CNA at 4pm and noted resident without pulse, respirations or BP. Resident DNR. Family at bedside. Call placed to DR Jones. Order to release body to funeral home received.

Thats the very basic note.

[HeatherLPN]

I always put that the absence of vitals was confirmed by another nurse and the time that was done.

[leslie :-D]

pt found w/o pulse, respirations. pupils fixed. md notified. order for rn pronouncement. spoke with dtr on phone. body released to _______fh at 4pm. pt was dnr.

[suebird3]

Resident found unresponsive; Absence of P/R/BP. Family, MD, Admin., and DON notified. Body released to...... If pt. is Hospice, we notify Hospice, also.

SueB ?

[leslie :-D]

I never understood the rationale of taking bp.

if you don't have a pulse, then isn't taking a bp redundant?

[CapeCodMermaid, RN]

"Resident with no pulse, no respirations, lack of pupilary response. Pt is DNR. MD notified. MD is unable to come to facility at this time. Order received for RN pronouncement. MD stated he will notify the family. Order received to release body to the funeral parlor."

I had a patient once whose wife refused to believe he was dead because she "didn't hear any alarm go off like on ER" I had to explain the difference between an 02 concentrator and a telemetry monitor and she still wouldn't believe her husband was dead. I had to call the doc to come pronounce.

[CapeCodMermaid, RN]

Always check your own facility's policy for RN pronouncements....and don't forget, sometimes the nurse CAN'T pronounce...an unexpected death, a death within 24 hours of admission (unless the person came in to die)...the circular letter from this state is about 3 pages long on when to call the ME.

[EbraLPN]

At 10am resident's respirations noted absent, RN supervisor notified. Resident assessed, BP/P/R absent, Pupils fixed. MD notified, new orders - RN Pronouncement and order to release body to funeral home confirmed by Jane Doe NP covering for Dr John Doe. Resident pronounced at 10.30AM. Body released to MacVille Funeral Home.

[Forever Sunshine, ASN, RN]

NYNewGrad said:

No one needs the EKG flat line printout?

We barely have functioning dynamaps let along EKG machines. lol

State in your note what you observed when assessing the resident, that a DNR was in effect, MD notified, family notified, and don't forget the time of death, and the time that the md and family were notified.

[suebird3]

We had one heavy set resident who was a beast in regards to pulses. Surprisingly, we could get a BP when rezzie was alive....

[NYNewGrad]

No one needs the EKG flat line printout?

[CoffeeRTC, BSN, RN]

NYNewGrad said:

No one needs the EKG flat line printout?

Not in LTC. No ekg machines.