Members are discussing the practice of how long a deceased person's body should be allowed to remain in a hospital room before being moved to the morgue. Some members mention experiences of bodies staying for extended periods due to family circumstances, while others question the 4-hour rule they have heard of. The discussion also touches on the impact on family members, hospital policies, and the process of decay after death.
Please forgive me if this is a dumb question, I'm a PCT and a nursing student............so I'm looking for all of your RN wisdom.
How long should a deceased person's body be allowed to remain in the hospital room before they have to be bagged and transported to the morgue? At my hospital, the rule I have ALWAYS heard is that the body has to be off the floor by 4 hours after expiring. I work in Oncology so we have quite alot of patients passing and in all of the post mortems I have done (alot) they have been taken down by 3 hours.
I'm asking this because we had a patient pass, all the family but one son was present. The son was on a plane flying in to see her but he didn't make it. That being said................before our nurse manager left for the day she said the patient could remain in the room until the son arrived, that there was no law that stated they be removed in 4 hours. This is contrary to everything we (our RN's included) have always heard. So we bathed her, removed cath, etc. at about 1 hour post death. The son arrived at 6 hours after time of death. We didn't get to remove patient until 6 1/2 hours after time of death...............NEEDLESS to say, this was disturbing. Rigor had already started to set in, smell started to be very malodorous, etc.
Also, time of death "appeared" to be altered on paperwork.......I know because I was just outside the room when my patient passed.
In the first case, we kept a body on the floor for 24 hours (!) because a son was flying in from India and didn't want to see his Mother in the "artificial" setting of the funeral home. It was a private room, we kept the door closed. I don't really remember the body smelling, but we sure we creeped out that night shift.
The second one a pt died in a ward (4 pts) family came to see her. And more family. And more family. they just kept coming and coming. I kept trying to be delicate - "Um, we need you to start leaving soon please" and then finally after 7 hours I gave up and said "You need to leave NOW so we can move the body. This isn't fair to anyone else in this room". The other pts were trying their best to give the family their space, but it was difficult - esp for the person right next door. The other two weren't quite as bad as our 4 bed wards look like 2 semi-privates - there is a wall down the middle, but only 1 bathroom. Of course, the person that died was on the bathroom side, but at least by the window. They finally left after 8 hours. I don't remember the body smelling. (and no, there were no privates to move the body into - all privates were either occuptied by isolation cases, the wrong sex to move, or aggresive pts who could not be in wards for safety reasons.) The most ironic part to this story is that this lady had been in hospital for over a month and had only 2 visitors come during that time. All this family that came to see her dead never came to see her alive.
You guys are so amazing to take the time to explain all of this stuff to me!
Like I said, we have alot of death in Oncology/Hosipce, but this was the first time someone stayed that long........and alot of the nurses were throwing a fit because it was past the "4 hour" mark..............One nurse said the body starts "changing" at that time and it was a health risk, but it was my first experience with a long family vigil, and with everyone up in arms about it- it creeped me out health wise.
From what everyone here said, and what I researched online is that rigor starts at about 4 hours, and the bacterial growth is the issue that initially causes the start of decay and causes an odor........but that it can start as early as 3 hours depending on the disease process, etc. that caused the end of life. The patient had Breast Ca. Ovarian Ca. with mets everywhere and visible palpable tumors throughout her abdomen................had intractable vomiting of brown, thick, bile looking stuff that one of the nurses said looked like it was tinged with fecal matter...............that very well could have been the odor just coming from inside after death.
I heard today that the alteration of the paperwork was just our Nurse Manager's way of buying the family some more time...............and I'm all about that.........so long as it isn't a health issue for us/family/etc.
Again, you guys rock and I REALLY APPRECIATE everyone taking the time to respond. The only way you can learn is to ask questions when you don't understand and I am grateful to have you all as a resource!!:redpinkhe:up:
:redpinkhe:up:
Pepper The Cat, BSN, RN
1,790 Posts
I've had 2 long episodes in my career.
In the first case, we kept a body on the floor for 24 hours (!) because a son was flying in from India and didn't want to see his Mother in the "artificial" setting of the funeral home. It was a private room, we kept the door closed. I don't really remember the body smelling, but we sure we creeped out that night shift.
The second one a pt died in a ward (4 pts) family came to see her. And more family. And more family. they just kept coming and coming. I kept trying to be delicate - "Um, we need you to start leaving soon please" and then finally after 7 hours I gave up and said "You need to leave NOW so we can move the body. This isn't fair to anyone else in this room". The other pts were trying their best to give the family their space, but it was difficult - esp for the person right next door. The other two weren't quite as bad as our 4 bed wards look like 2 semi-privates - there is a wall down the middle, but only 1 bathroom. Of course, the person that died was on the bathroom side, but at least by the window. They finally left after 8 hours. I don't remember the body smelling. (and no, there were no privates to move the body into - all privates were either occuptied by isolation cases, the wrong sex to move, or aggresive pts who could not be in wards for safety reasons.) The most ironic part to this story is that this lady had been in hospital for over a month and had only 2 visitors come during that time. All this family that came to see her dead never came to see her alive.
Go figure!