Pronouncing Death


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.

Has 18 years experience.

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


7,735 Posts

Specializes in retired LTC.

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


1,262 Posts

Specializes in PICU. Has 17 years experience.

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

Specializes in Mental Health.

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.


20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 26 years experience.

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

Specializes in Medicolegal Death Investigation; Forensic Nurse. Has 28 years experience.

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.