I Gotta See If He Is Dead!

[spotangel]

I had a strange sense of anticipation as I walked in. Working as a perdiem Nursing supervisor(Assistant Director of Nursing) in a busy hospital, I had strongly felt that I needed to put myself down as available for this Sunday shift a month ago. I avoided working Sundays as they were packed between church,religious education,dance class for my daughter and home cooking. Now I was here.

As I walked into the lobby, two relieved security officers came hurriedly towards me.

"Thank God you are here! We need your help!"

What's the matter Officer Davis? How can I help you?", I calmly asked as I watched the ED social worker turn the corner and come towards me. They all began speaking and I held up my hand and smiled.

"One person please!"

The social worker told me the situation. There was a family in the emergency room. They were very upset. Their brother was missing for five days and they finally found out that he had been brought to this hospital. The doctor told them in the ED that their brother had a major heart attack and had been brought in dead. The family went shocked, angry and upset. There were two siblings in the ER, a brother Tom who was mentally challenged and had lived with the patient and a sister Sara who took care of five brothers, four with special needs (two lived in Ohio) and the patient Ron, who had been brought in dead. She wanted proof that this was her brother. She wanted to see Ronny's body and his belongings.

Our hospital allows patient bodies to be seen in the morgue only under special circumstances. I showed the social worker how to locate his belongings on our EMR and asked him to see if that would suffice. I told him to reach out to me after report.

I got report from the night ADNs who told me flat out that they were not going to the morgue - period! I wasn't hot about it either as the patient had been in the morgue for five days. I prayed that the belonging was enough proof. After report, I was relieved that I was not covering the ED. The other supervisor was!

The social worker reached out to her and was told to tell the family that they could not see the body. The social worker, not knowing what else to do, then reached out to me as the brother Tom was yelling, screaming and having a meltdown in the ED and had been escorted out by security but the family was refusing to leave. I discussed this with the other ADN and offered to go speak to the family. She consented and I went down to the ED.

I approached the sister Sara who was methodically taking out everything from the patient's bag ( which the social worker had found) and looking at them. I offered my condolences and asked her what I could do to help her. She told me that she wanted to see his body and that her other sibling Marcus was on the way.

Tom was sitting outside the main entrance and was not allowed back in for the time being. Security told me that they were waiting on cops.I told them that I would talk to Tom. I slowly went towards him and stood a little away.

"Hello Tom. I am Annie, the nursing supervisor."

No response.

" May I talk to you?"

No response.

"I am so sorry that you are sad. I wish I could help you".

He suddenly turned, his eyes bloodshot. My heart was in my throat as I did not know what he was going to do!

He burst out, "It's not true! He's not dead! "Sobs racked his body. I inched closer.

"May I sit down?"

He nodded. He thrust his phone towards me, speaking with a lisp, "Look! I called him so many times. He did not answer! He did not answer!"

Tears pricked my eyes. I was looking at a 56 year old who drove a car but had the mental capacity of a five year old.

"I am so sorry! He could not answer you as he died" I said softly. I inched closer to him and now was sitting next to him. He put his head on my shoulders and cried.

After a while he sat up, looked at me and said, "It's ok. It's not your fault".

I saw the cops pull up and I signed that it was ok. They kept a watchful distance. Now that I had got him to calm down I asked him if he would like something to eat or drink. He asked for water and so I went the ADN office and got him Graham Crackers and water. He thanked me! I then told him to call for me if he needed me and went back into the lobby. Sara who was sitting in the main lobby told me that she was waiting on Marcus who had psych issues! I spoke to security and asked them to inform me when he arrived and went on rounds. I got paged two hours later that Marcus was there and was having a huge argument in the lobby.

I went down and spoke to them. Tom had left as he wanted to grieve by himself. Marcus was in my face and Sara was trying to calm him down.

He kept saying, "I gotta see if he is dead!"

I spoke to security in private and we decided to show them the body. I went ahead with security, put on gloves and mask and prepped the body for viewing o a stretcher. We put a screen around the body.We then went back and told them to follow us. I held my breath as they peeked around the screen.Sara took one quick look and said, 'That's Ron!" and walked out. Marcus stood and stared at his brother and said, "He's gone! My brother is gone" and started weeping hard. Security gently escorted him while the other security and I put the body back in the morgue.

We then escorted them to the lobby where they sat and did not want to leave as Ron was there! Sara showed me a phone video she had taken the week before he died. Ron playing with his dog in the park. Ron looked healthy and happy.

I gently suggested that they go home and finally they left. I thanked the team for working together professionally and helping a family with special needs in grief. The cops had long gone. I went home after my shift and listened to my kids arguing and kidding with each other as my husband and I enjoyed our coffee. I felt blessed to be alive and surrounded by life though my heart ached for Sara, Tom and Marcus.

Special need patients and family need extra careful handling and caring in times of grief. The situation could have escalated if not for the team working together as one. We could not save Ron but we stood together to help his family.

[crazy2]

Really?! your trying to find fault? God Bless spotangel as a psych nurse of 29 years her handling of the situation was "Spot on"

[calivianya, BSN, RN]

For those of you talking about visitors in the morgue...

I work in a 900+ bed hospital and neither one of the morgues can hold more than five bodies... it's sad how pitifully small they are, especially for a hospital of this size. Both morgues themselves are maybe 7 feet by 7 feet, tops, and the morgue anteroom in the main morgue is maybe 8 by 10 feet (the ED morgue has no anteroom), with no furniture of any sort, no railings, and solid tile floors and walls. There's nothing to catch visitors if they fall, and if they do fall, they're going to hurt themselves.

Maybe some of you guys have morgues that are more visitor friendly, but there is absolutely no way visitors could fit in our morgue, just for space and safety reasons alone. Not to mention the morgue is secured by public safety and they have to stay for the whole duration of the time the morgue is unlocked, so it would tie up a public safety officer for the whole time a family was down there. We need our public safety officers to be doing public safety things, personally, and not babysitting patient family members. We don't have very many of them on at a time as it is.

We had a situation once where the patient died in the OR and all of the periop areas were full, so the declared dead body was brought to an empty ICU room so the family could visit. We had several empties that day, so it wasn't a big deal. The morgue was definitely out of the question, for all of the reasons mentioned earlier.

It's honestly kind of hard to imagine the type of morgue a family member would be safe to walk into, for me...

Spotangel, you did a great thing.

[marie.rn2419, RN]

Why would people need "special circumstances" to see the body of a loved one?

I was thinking the same thing. Also, out of curiosity, because this situation involved a patient brought in to the ER deceased, did someone positively identify the body? If so, why was the body held there for 5 days?

I can understand the family wanting to verify that this is in fact their loved one that is deceased... Not exactly a special circumstance. Sounds like your team handled this well, though.

Edit: I hadn't seen OP's further statement that they were "pretty confident" that this was the right patient based on an ID being at the scene that matched the address... I'd feel uneasy officially confirming the death of "Ron Smith" because the medics picked up a dead white male in his 50s from the address of a white male in his 50s, with no further 3rd party identification. Just my opinion.

[spotangel, DNP, RN, NP]

Opinion appreciated! The patient had called 911 and complained of chest pain and he had identified himself. While EMS was at his house treating him, he had a massive MI. ACLS protocol was followed and he was brought to the ER, CPR in progress. So yes, we were confident of the patient's identity. He had called from his cellphone and the phone was on him when he came in along with his backpack. His home phone number on our EMR was a number that was disconnected and there was no other emergency contact as he took care of his younger sibling who was mentally challenged.The younger sibling was in adult camp and was not at home.The body was held in the morgue as no one had claimed the body.PD was aware but there was no one at home to notify. Finally the sister who lived somewhere else initiated the search when he went missing.

[spotangel, DNP, RN, NP]

Thanks! First do no harm---!

[spotangel, DNP, RN, NP]

5 visitors were not allowed, only 2; the sister who held it together throughout out the day and the brother Marcus who insisted that" he gotta see his brother and make sure that he was dead!" Two of our burly officers accompanied us to the morgue and the family stayed probably 5 minutes . One of the officers built a rapport with Marcus and comforted him and gently lead him out after the viewing.After that ,we sat in the lobby(while my pager was going off like crazy from the rest of the hosp units I was covering!) and watched a phone video of Ron while both of them laughed, cried and talked about him!They kept lingering and I was gentle but firm and told them them that they needed to go home and rest. I also gave them the protocol of what to do next in terms of getting him into a funeral home.It was a long day for all of us!

[marie.rn2419, RN]

Opinion appreciated! The patient had called 911 and complained of chest pain and he had identified himself. While EMS was at his house treating him, he had a massive MI. ACLS protocol was followed and he was brought to the ER, CPR in progress. So yes, we were confident of the patient's identity. He had called from his cellphone and the phone was on him when he came in along with his backpack. His home phone number on our EMR was a number that was disconnected and there was no other emergency contact as he took care of his younger sibling who was mentally challenged.The younger sibling was in adult camp and was not at home.The body was held in the morgue as no one had claimed the body.PD was aware but there was no one at home to notify. Finally the sister who lived somewhere else initiated the search when he went missing.

It sounds like a complicated situation that you guys did the best you could with!

[klcrn1987]

I'm not sure in this case but you also have to think of the condition of the body... sometimes it's not "wise" to have family members see the body in the morgue before they can be prepared by a funeral director..

[spotangel, DNP, RN, NP]

That is always in the back of your mind. In this case there was pooling body fluids. So I literally mopped up the body before we transferred him to the stretcher. Not pleasant at all. Need a tough stomach and a tougher mind!