Patient Death Notice BOMBSHELL! HELP!

cuba757 · Jul 18, 2013

When I worked in LTC, there was no policy in place to notify staff of a patients death on their days off. However, I would sometimes find out from other staff that I kept in contact with outside of work. With that said, when I came back to work from days off I always do my rounds first. Then I would check the 24 hour report from the days I was off to see what has been going on. We used a 24 hour report to relay important happenings from each shift for ex: new admits, new orders, start of ABTs, hospital transfers, patient deaths, etc. So, if I didn't already know about a patient dying before the start of my shift, then I would/should definitely find out when I check the 24 hours. The nurse should remove meds from the cart after a patient passes away but sometimes that happens for whatever reason, maybe she was really busy or not :-). After I do my rounds and notice a patient was not there, I always asked the nurse I was relieving. They should be able to tell you most of the time. Hope that helps!!!

SitcomNurse, BSN, MSN, EdD, RN · Jul 18, 2013

Im sorry this happened to you. Where I am, we report to the nurses we see, when see somenone/anyone is back from a day off or a week off.

Also, our computer system takes out all info upon 'discharge' for any reason, and .. from this point I can only say, if communication is nto forth coming in this regard, you can alsways ask when getting report..

Are there any dishcarges for any reason?

It may be that 48* later, in that LTC facility it is 'old news'.

Some residents we talk about for years, some we dont.

The nurses on duty in the previous 48* should have removed the medications too, and returned them to pharmacy.

Again, Im sorry you found out this way.

CT Pixie, BSN, RN · Jul 18, 2013

I would have been notified by my shift report. Our reports go down the list of every patient.

Room 101 is fine, nothing new, 102 has s/s of a URI call out to the doctor...waiting on his return call, 103 is empty, 104 has a procedure tomorrow and needs a bowel prep Me: 103 is empty? Where is Mr/Mrs X? Offgoing nurse: passed away yesterday/day before.

I usually tell the off going nurse (we work the same unit all the time, and have the same days off every week) "I haven't been here since X day..anything change between then and now?

But even if the info of an empty room missed my attention, I would notice when I do my walking look/see rounds right after report. And empty bed w/no linens on it would clue me into either A) Patient in hospital or B) Patient D/C or C) patient passed. Since most of my patients are LTC the chances of a d/c are slim. I also check the 24 hr reports for all the days I was not there (I only work 3 days/wk) just to keep up on whats been happening since I left.

SleeepyRN · Jul 18, 2013

I don't understand why you weren't told in report. Does your facility not do quick rounds at the very beginning of your shift? I literally just looked at each of my residents real quick and just made sure they were breathing. Even then though, if I hadn't been told in report that a resident passed away, upon doing my initial rounds, I would still be kind of shocked. I'm sorry you had to find out that way.

miasmom · Jul 19, 2013

Aww. Lousy way to find out. You must have cared for them. Some of the patients touch our hearts thamothers. Some we know for yearsa nd come on the next day. Gone. Hurts. Sometomes I wonder which is easier/harder . Unexpected or long death. Sniff

Meds still in cart? Wrong. Good catch. Gentley remind everyone the errors and possible outcomes. I am still at place that still uses paper MARS and that jist adds to confusion.

mlbluvr · Jul 19, 2013

I can't say how many nursing home patients I've found dying, or already dead, or on the floor in a pool of blood, or passed out sitting on the toilet, or etc. after I made rounds after receiving 'report' in nursing homes. Hence, my tactic is always to get 'report' over with as fast as possible so that I can go make rounds and find out what's going on, really. I gave up trying to get a prior shift nurse to make walking rounds about 50 years ago. It's a struggle to try to force accountability, that seems will never be accepted. As far as finding out a patient has died, well- that means a bed is empty...and we all what an empty beds means. A possible ADMIT.

fairyluv · Jul 19, 2013

where I work, when we give report we go down the list. so and so in rm 1 ok, nothing new, so an so in rm 2 started abt today, so an so in rm 3 had passed the other day on whatever shift and this is what happened to them and we have new res. in that rm. now, this is there status. and if the off going nurse skipped someone i will usually ask about that specific res....I can't always do a quick round down the hall right away, when I get there, we have so many activities goin on with the activities director that I can usually eye ball most of my res in the activity rm playing bingo, getting nails done, ect or they are in the therapy gym...and if someone who usually attends the activities is not there, and not in the therapy gym, then I will ask one of my aids where they are, there are times when a res. has gone out on pass and I was never told, but the CNA's give each other report and my aids can usually tell me where everyone is and if anyone is out.

sorry you found out about your res that way. Hopefully the communication will improve.

chrisrn24 · Jul 19, 2013

Typically we will say it in report. "Did you know so and so passed?"

KRSLPN, LPN · Jul 20, 2013

This thread confused me. Were you upset that you weren't notified that someone passed on your day off by someone phoning you at home or are you upset that this person's passing wasn't mentioned in report?

ricksy · Jul 20, 2013

Not mentioned in report, not taken off emar, pills still in med cart. Original post:except I didn't learn it on handoff report or when I reported to work. We have EMARs and total computerized. Although someone had taken him off out of the computer, as sometimes happens, his info still showed up as meds due. Meds were still in cart.

kmarie724 · Jul 20, 2013

We have a Checklist for Death of a Resident that we follow which includes things like DCing all their orders in the computer and removing medications from the cart to prevent things like that from being missed. If someone has passed in the past few days, I mention it in report, especially if I know the nurse following me has not worked the past few days. If the family gives permission (which they almost always do) we also post a note by the time clock with information about when and where the visitation/funeral is.