Neuro ICU - Do you talk to brain-dead patients? - page 15

I'm about to begin a Masters research project about ICU nurses talking to brain-dead patients (oh the joys of ethics approval committees!). My interest in this started when I read 'Rethinking life... Read More

  1. by   deeDawntee
    I believe that the body is temporary, but the soul lives on forever. I also believe that the soul may and probably does hang around for awhile after it has left the body. So when I talk to my brain dead patient, I am talking to what I consider to be their spirit in the room with me, observing what I am doing. I like to tell them things like acknowledging their life, and that their journey is over and they get to go home now. Or acknowledge what a good job they did with their kids, if I had met them, etc. I have done some reading on near death experiences, and I do believe that it does describe the death process.

    Of course, if family is in the room, I don't do this kind of thing, but will send them thoughts instead. Very positive thoughts. If they are going to be an organ donor I send huge thoughts of thanks to them, or say it to them if I am alone with them.

    Hopefully that isn't too weird for some of you...but we all do what we have to do to cope with death, I guess....
  2. by   bethin
    I realize this is an old thread but I have to throw my 2 cents in.

    Are we causing any harm by talking to brain dead pts? I'm not seeing the harm. The pt is dead and I don't think that we are dillusional if we do.

    I do talk to the brain dead and comatose pts. If I don't I feel like I'm a robot sent to do a job and they are the job, and I'm just there to get done with as little effort as possible.

    As an aide sometimes I don't know the latest prognosis. I'd rather look like a fool talking to a dead person than not talking to a live one.
  3. by   Sabby_NC
    Wow this has been an interesting thread to read.
    I have only ever been in contact with one brain dead person waiting on organ harvesting and I remember I was speaking to her as I was attending to the 'machines'.
  4. by   NeuroMedic
    Absolutely. Just because they are brain dead does not mean that I will treat them with any less respect than I would when they were cognizant(if they were cognizant). Respect is an important part of nursing. Would you leave a cadaver nude in the middle of the hallway? After all, they do not know they are nude. This is definately something to think on.
  5. by   mammoset
    I strongly agree with Elkpark, thanks for sharing.
  6. by   blueheaven
    Quote from caroladybelle

    But then I have been known to talk to patients while doing post mortem care.
    Amen to that! I talk to everyone that has ears! I talk to the "brain dead" ones just as I do to the comatose ones. It is just me, and has nothing to do with "not accepting the fact" that they are dead etc. My personal belief is that if the body itself is still breathing, heart is pumping, the soul who lived there may still be connected.
  7. by   algRN
    I talk to my unresponsive pts. in case they may be able to hear us. But as mentioned above, brain dead is dead.
  8. by   Zookeeper3
    for me, I talk to them simply because they are still my patient and I'm providing care (harvesting or awaiting withdrawl with the family grieving time). I just can't perform care and not "discuss" it with the patient because of a brain death declaration, sometimes we have them 24 hours while harvesting. It's part of my practice but I don't feel it's a negative with those who don't, just a different belief system about end of life.

    this was a great thread to read, learned from everyones input!
  9. by   valkyria
    i can tell you that as a coma patient who came back after i was resusitated twice, i thank you nurses who do treat all your patients as if they are really there. in case you are not sure, what harm would it do? for those who get the willies with post mortem care, talk to them about how wonderful the journey is they are on, it really is. talk about how beautiful the place they are going is, it really is.that will make them human again and you will not be nervous anymore. i had to do post mortem care on a patient the day i came back to work after i held my grandmothers hand as she died in our home. i talked. trust me. when i was chosen to pack my grandmothers things away, i talked to her as if she were still there. she may not have been but it made what i was doing easier for me. they do not stop being our patients after they are gone. that is perhaps the most important nursing care we will ever do for our patient or their family. we must care for the living that are left behind. those are the memories i hold most dear in my short career. now i am doing research, that sensitivity is still important to hold on to when talking to patients and their families.
  10. by   Zookeeper3
    After organ percurment comes and we're harvesting, family says goodbye and leaves... it's just me and the brain dead patient... fighting to keep every organ going... to keep another alive, what an outstanding process!

    Might sound creepy, but I give encouragement, talk... rub an arm.... talk about continuing to live through another... giving life to another. I KNOW, the brain does not compute and I'm not religious but a part of me believes in a soul... a part of a human being living on. Don't we all have hopes that that finality isn't that final? Don't we all worry that this can't just be it?? We're done and gone?

    I am unable to do anything to a "living" body, sentient or not.. and not explain my actions in advance. We lack so much truth and understanding that to not do so, to me, would be well strong word forgive me for it, but violating my pt. And Yes, I know they are brain dead.. but I still am caring for a physical body and I've been taught better than that. Until I know for certain brain death is the end all and be all and that's it... ashes to ashes.... no more.... we'll I'll just chat away mean while in attempts to provide comfort, no matter how ill placed it may seem. It didn't cost me any more work or time and I feel better about myself for the effort.

    I love this thread, read it twice, responded twice. It reminds me of why I clock in... I'm a better person with these experiences and I'm proud of my practice. Maybe talking to brain dead patients gives me personal closure, but I've never felt incomplete when I've left.
  11. by   Designer NP
    I speak to all my patients regardless of brain death or not. It just seems so cold and unlike me not to. I don't like treating people like a slab of meat. This person was once alive a mother, daughter, father, son....They deserve respect in life and death. What harm may arise? None.
  12. by   judytheoldrn
    NurseCutie, I agree, I talk to all - I don't believe in any way that they will hear me, but it's a way of cleaning out all the debris in your head before you move on to the next poor guy. I do, however, make it a point to not talk to my brain dead patient in front of family, especially if they are having a hard time realizing the person is really dead. Like in the case of a family who is resistant to removing life support once brain death has been confirmed. I feel like if I talk to that patient, it will just reinforce to the family that the patient is NOT dead!
  13. by   Designer NP
    I understand what you are saying about not talking to them around families who are in denial about brain death. That would confuse them even more. I always talk to my families too. I ask them if there is anything I can get for them and explain the whole process. Even though I may not speak to the pt in the families presence I still give the body the upmost respect, considering they were once a living, breathing person.