Pronouncing Death

[MyAimIsTrue, BSN]

At my hospital most patient deaths are "RN pronounce," which means you don't need a doc to call/confirm it. I appreciate that. But is there a specific methodology to confirming death? I had a comfort care patient die last week and it was my first RN pronounce (and yes, you do need a second nurse there). I felt for carotid pulse, observed no respirations and the other nurse listened for heartbeat with her stethoscope. But is there more to it? Do you need to listen for a specific amount of time? I will admit I got a little paranoid later and thought, "What if we sent him to the morgue and he wasn't dead!" Obviously I should have asked at the time, but I didn't, and it seems terrible to ask after the fact.

I'm still a newish RN BTW.

[Closed Account 12345]

Have you verified that it is within the scope of RNs in your state to pronounce deaths?

[amoLucia]

In NJ, RNs could pronounce in nsg homes. But I don't think they did in the hospital. They always had MD staff around.

[RNNPICU, BSN, RN]

You would need to check your nurse practice act but I think in many places listening for a heart beat or absent heart beat for 5 minutes.  check your state though for how long someone should listen.  5 minutes is a good rule

[Rionoir, ADN, RN]

I work at a inpatient hospice facility - we always document that we listen for absence of pulse and breathing for one full minute. You might see some apneas that are pushing a minute at the end, but you'll still hear a heartbeat.

If you haven't been trained to pronounce I'd lookup state laws for what your obligations are there.

[SmilingBluEyes]

I agree with those saying check with your state to be sure it's in your scope at all.

[SADrake718, ADN, BSN, MSN, PhD]

Hi MyAimIsTrue BSN:

I hope this email finds you well. I agree with what has been stated about checking scope of practice within state. I would add that you should check your agency policies/procedures. If one does not exist I would encourage you to take on this service!  If one does exist I would encourage you to ask your educator provide an inservice.  Happy to assist you in any way.