Here's a question for all of you ER nurses (sad and kind of long)

[Lisky90]

Today my uncle died, he was 54. He was diagnosed with stomach cancer two months ago. Today he was having chemotherapy, he had 15 minutes left to finish the infusion when he started to feel nauseous. He coughed up some blood and within minutes he was vomiting blood and went into cardiac arrest. He was a full code, but he did not survive. This was very sudden even though he was most likely terminal - the cancer had spread to many other areas and he was not responding well to the chemo, but no one ever suspected he would have died, today. My aunt was not with my uncle when he died; my uncle's sisters took him to chemo today to give my aunt a break. By the time she was called and arrived at the hospital it had been almost a full hour that he had been gone. When she was brought in to see him she almost fell over - he was left uncovered with all of his clothes cut off, defib pads still on his chest, IVs, ET tube, and covered in the blood that he had vomited...an absolute mess. My cousins all proceeded to walk in, as did his elderly parents, etc. They were all horrified to see him in this condition. It was explained to them that since they were not going to consent to an autopsy, that he needed to remain in this condition until the medical examiner signed off on the autopsy form. I understand that procedures need to be followed...but this was not a crime scene...he had terminal CA. I don't understand why his body could not have been covered with a sheet or his face washed - this is now my aunt's, my cousin's, and his parent's last memory of him. My family sat in the Er waiting room for five hours waiting for the medical examiner who still had not come when I was leaving. My aunt can't proceed with funeral arrangements...she can't go home. It's just a horrible situation...am I wrong to be upset with how things have gone? Is this just routine procedure? If anyone has any idea or thoughts they would be appreciated.

[chelli73]

i have no words for your situation other than my heart goes out to you and your family. God be with you during this terrible time.

[vamedic4, EMT-P]

Lisky I'm very sorry to hear about your uncle. It is also very true that your uncle's body could and SHOULD have been covered to prevent the very situation you describe above. Someone also could have cared enough to wash his face, clean him up just a little prior to family being there. To me that is utterly disrespectful of the dead, regardless of how busy the ER may or may not have been.

I am very sorry for your loss, and you have EVERY right to be upset at this situation.

vamedic4

[Kim O'Therapy, BSN, RN]

I am sorry about the loss of your uncle. I would never have left a patient in that condition, especially if family members were going to be viewing him/her. I don't blame you for being upset.

[marybethm]

I agree with everyone else. There is NO excuse for the care that was not taken to treat your uncle's body with respect. I would raise the roof on this one. You have every right. Someone (or three) should apologize to your family.

[prmenrs, RN]

First, I need to say I'm terribly sorry about the loss of your uncle. I'm also sorry that it happened so suddenly.

If, for whatever reason, it was decided that is might be considered a coroner's case, the rules regarding that mean you have to leave everything as is til the coroner arrives or waives the case. That is probably the reason for leaving the mess. The coroner (unless s/he waives the case) must document every tube and wire and IV, etc., in place @ the time of death.

That said, it would have been much better if the family had been warned what the room and body looked like, and accompanied into the room by an RN and social worker or chaplain. And I'm sorry that was not your experience.

My condolences to your family.

[tridil2000, MSN, RN]

First, I need to say I'm terribly sorry about the loss of your uncle. I'm also sorry that it happened so suddenly.

If, for whatever reason, it was decided that is might be considered a coroner's case, the rules regarding that mean you have to leave everything as is til the coroner arrives or waives the case. That is probably the reason for leaving the mess. The coroner (unless s/he waives the case) must document every tube and wire and IV, etc., in place @ the time of death.

That said, it would have been much better if the family had been warned what the room and body looked like, and accompanied into the room by an RN and social worker or chaplain. And I'm sorry that was not your experience.

My condolences to your family.

it is a coroner's case, as he died suddenly within 24 hours of being in a hospital.

i am so, so, so, sorry that your uncle was left this way. he should have been cleaned up and covered with a gown and sheet. the et tube could have remained, as well as the pads and ivs under the sheets. i always leave a hand outside of the sheet so family can touch it if they want.

after 3 hours, the body needs to be flat and put on a cooling blanket as well. we've had to hold bodies for long times... waiting on family members etc.

you need to call the medical director of the er and the nurse manager on this one. completely unacceptable.

my sincere sympathy-

:icon_hug:

[NurseWilliam]

First, please accept my most sincere sympathy for your loss.

Having read the posts of others who mentioned it being a coroner's case, I concur that it is important to leave everything on /in the body. However, IMO more care could have been taken by the care team. Simply covering him up to the chin with a clean sheet would have made a big difference. I personally cannot give you an answer why that was not done.

[LeahJet, ASN, RN]

My deepest sympathy for you and your family.

Even though the ET tube, IV, Foley, ect....need to be left in for the coroner, I always clean the patient and put a sheet over them. AND I always try to prepare the family by telling them that the tubes are there and give them the option of viewing or not.

I once had a family come in before I was ready (miscommunication with the front desk) and I felt really bad the family saw their loved one in that way. I did apologize and they understood...but I will always think that "picture" stays in their mind.

[caroladybelle, BSN, RN]

My deepest sympathies on your loss.

I regret that your family saw your loved one like that. But many facilities have policies in place, that when an unexpected death occurs, until the case is ruled that it is not a coroner's case, the patient is not cleaned up, and everything, including tubes, IVs, etc. is left intact. This policy has occurred as a response when familys have sued facilities for alleged misconduct, malpractice and of "covering up" misconduct by disturbing the "evidence". In some places that I have worked, we are not even permitted to clean the face or change the soiled gown, as there might be "evidence" therein disturbed. This occurs especially in cases of unexpected death because there will be a lot of questions.

That said, we often do everything that we can to make the deceased as presentable as we can, without breaching these policies, which vary from place to place. We also try to brief the family to the issue. We cover with clean sheets what we cannot make more presentable.

If I had my choice, a family would never see their loved one that way. But unfortunately, because of current legal climate, hospitals have developed these policies.

[debbyed]

As with the others you have my sympathies. Regardless of whether a patient is an M.E. case both the patient and the patients family need to be respected. If the family was not at the bedside during the code, than the physician should meet with them prior to explain everything that happened including any disfigurements (ET tube, NGT etc). It is the Nurses responsibility to make that patient as presentable as possible prior to family viewing the patient. The patient can be covered with clean sheet/blankets and I always leave the least affected hand out for the family to hold. I'll place chairs at that side of the bed for them.

What you experience was unacceptable regardless of where you are (unless the police have custody of the body, than family usually aren't allowed to touch the person and sometimes not allowed in the room)

I would think this type of behavior would do more in promoting the family to question legal action than if you and the patient had been treated with the respect and dignity you all deserved.

I would strongly suggest that you request (make that demand) a meeting with the hospital administrator and the nurse manager. I know it won't help you or your family but it may keep another family from having the same nightmare as you.

[indigo girl]

I am very sorry for your loss, and for the way your family had to view your uncle. They may not have the energy to deal with the hospital at this time.

I do hope that they will later, or perhaps designate another family member to do so.