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The nurse in the morgue – Part 3 of my interview with a forensic nurse

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SafetyNurse1968 has 20 years experience as a ADN, BSN, MSN, PhD and specializes in Oncology, Home Health, Patient Safety.

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Autopsy Nurse in the Morgue

What does an autopsy nurse do? I interviewed Lacy, a forensic nurse who spends part of her workday in the morgue. This is an interesting nursing job I had never heard of. In part 1, I covered the basics of forensic nursing. In part 2, I described the daily life of a forensic nurse.

The nurse in the morgue – Part 3 of my interview with a forensic nurse

Did you know? Forensic Nurse is sometimes called "autopsy nurse" or "death investigator".

You may have read part 1 and part 2 of this series about Lacy, a forensic nurse who spends part of her workday supporting victims of sexual assault, and part of her day working in the morgue. I didn’t have space to discuss the work she does in the morgue, which I found to be intriguing. It’s one of those Nursing Jobs you don’t hear about much, but it’s so important. I did some research and discovered that this job title is sometimes called an “autopsy nurse” or “death investigator.” These nurses often work with a coroner or medical examiner (ME) to determine cause of death.

Lacy described her work in the morgue, “If a patient dies in the hospital, the nurse fills out the death packet and then we got to the unit and collect the body and bring it down to the morgue to wait for the funeral home to pick it up. Bodies come in from the outside as well, from overdose or motor vehicle accidents. Sometimes we assist the medical examiner with collecting evidence if they need our help. They decide if the decedent goes to autopsy. Those are done in the [state capital]. Or the hospital can do an autopsy on request, but that’s a whole different system.” She went on to say, “If the ME is on the scene and they lock a body bag, we don’t touch it. Sometimes the ME will decide they don’t need to investigate the site based on the officer’s report. We will then document belongings, do a pill count, inventory the body. It’s usually car accidents, OD, suicide. We have to be careful about lifeshare, though that’s usually not an issue with a fatal demise like an OD, but people who die in the hospital, the nurses are good about notifying lifeshare if there’s an organ donation. That doesn’t happen very often. 

Lacy described her first case in the morgue: “I was orienting with another nurse and a car wreck came in. I was nervous about what I might see. The nurse I was orienting with told me it might bother me the first time, but that I would get used to it. We had just opened the body bag when his cell phone rang. It was in his pocket. I just looked at her and was like, ‘what are we supposed to do’? She said, ‘we just turn them off and inventory the phone.’ It freaked me out, I was not expecting to hear a cell phone ring.”

She recalled another tragic moment, “A father and mother were in a car wreck. Mom was ejected from car, baby was ejected from car, dad was in neurotrauma on a vent. The infant was able to donate valves, and the decision to do that had to go to the grandparents to decide. That was a tough one.”

“The overdoses can be difficult when you deal with the family. It’s one thing if their kid has been in rehab, if they know drug abuse is happening, but the ones who have a son at college here, and the family is from [far away]– they have no clue their kid is doing drugs. The family is surprised and devastated. It adds another layer.”

What is the role of the nurse as coroner or medical examiner?

As I mentioned in Part 1, Nurses can actually become coroners or medical examiners. According to the International Association of Forensic Nurses (IAFN) the responsibility for death investigation lies with either a coroner or a medical examiner.1 A coroner is an elected official who may or may not have specific educational requirements. A medical examiner is typically an appointed physician with training in forensic pathology. There are currently 11 states that have coroners, 22 with medical examiners and 18 that employ a combination of both. I was curious about my state, so I googled death investigation in my state and found the Office of the Chief Medical Examiner. I ended up calling the office and found out that nurses can be MEs in my state. It is highly recommended for this job that you earn certification through the American Board of Medicolegal Death Investigators(ABMDI).2

I read several interesting articles about nurses who work as Medicolegal Death Investigators (MDI). Job responsibilities include taking photographs of the body, the evidence and sometimes even the crime scene. They work closely with law enforcement to determine exactly what has happened when an unwitnessed or suspicious death occurs. These nurses must have excellent documentation skills and are often called upon to testify about their findings. The downside is on-call hours, being called to scenes no matter the weather, and the disturbing scenes that MDIs may witness. The benefits include providing resolution for family members, and never seeing the same thing twice.3

The U.S. Department of Justice has published crime scene investigation guidelines.4 You can read through them by clicking the link. As in so many areas of medicine, crime scene investigation suffers from a lack of standard expectations. I was surprised to learn that there is no system of death investigation that covers the more than 3000 jurisdictions in the U.S. No nationally accepted guidelines or standards of practice are mandated for death scene investigations. There is no professional degree, license, certification or minimum educational requirement; there is not even a common job title for the thousands of people who routinely perform death investigations in this country.

I went to the ABMDI website to see if there were any jobs for MDIs in my state. The closest one I found has a starting salary of $40,000 and the minimum requirements are a Master’s Degree in a related field or a Bachelor’s degree with three years of experience in death investigation. However, I kept reading and it states that if a person with current ABMDI certification applies for the job, they will be considered. 

I don’t think I’m ready to go out and get ABDMI certification just yet, but I continue to be fascinated by the idea. I’d love to hear what you think about this nursing job, especially if you have experience in this field.

REFERENCES

  1. International Association of Forensic Nurses: The Forensic Nurse as a Death Investigator
  2. American Board of Medicolegal Death Investigators (ABMDI)
  3. American Nurse Today - Nursing the Dead: Medicolegal Death Scene Investigation
  4. U.S Department of Justice Death Investigation: A Guide for the Scene Investigator

Dr. Kristi Miller, aka Safety Nurse is an Assistant Professor of nursing at USC-Upstate and a Certified Professional in Patient Safety. She is also a mother of four who loves to write so much that she would probably starve if her phone didn’t remind her to take a break. Her work experiences as a hospital nurse make it easy to skip using the bathroom to get in just a few more minutes on the computer. She is obsessed with patient safety. Please read her blog, Safety Rules! on allnurses.com. You can also get free Continuing Education at www.safetyfirstnursing.com. In the guise of Safety Nurse, she is sending a young Haitian woman to nursing school and you can learn more about that adventure: https://www.gofundme.com/rose-goes-to-nursing-school

10 Followers; 44 Articles; 14,841 Profile Views; 237 Posts

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0.5GPA is a CNA and specializes in Boringly average Tech.

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Neat! Many moons ago I wanted to be a  forensic pathologist but didn’t want to go to med school blah blah blah. I read it is also the medical specialty with the oldest age of retirement so there is not many jobs like it.

Defiantly would interesting. Every time I would look to see if something like this existed I’d always get SANE nursing (I guess that what Google thought I meant) 

I’m a guy so I doubt being a SANE nurse would be very useful due to comfort of women an all. (I get that)

Autopsies that would something different especially to those who seek no real patient interaction lol

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SafetyNurse1968 has 20 years experience as a ADN, BSN, MSN, PhD and specializes in Oncology, Home Health, Patient Safety.

10 Followers; 44 Articles; 237 Posts; 14,841 Profile Views

11 minutes ago, 0.5GPA said:

Neat! Many moons ago I wanted to be a  forensic pathologist but didn’t want to go to med school blah blah blah. I read it is also the medical specialty with the oldest age of retirement so there is not many jobs like it.

Defiantly would interesting. Every time I would look to see if something like this existed I’d always get SANE nursing (I guess that what Google thought I meant) 

I’m a guy so I doubt being a SANE nurse would be very useful due to comfort of women an all. (I get that)

Autopsies that would something different especially to those who seek no real patient interaction lol

Thanks for commenting, 0.5GPA! Do you think you could actually do it? I've done some pretty gnarly wound care... Is there anything about it that you think would trip you up? smells? I think children would be my breaking point. I'd like to be on the list for adults only, but I don't think it works that way.

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0.5GPA is a CNA and specializes in Boringly average Tech.

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23 hours ago, SafetyNurse1968 said:

Thanks for commenting, 0.5GPA! Do you think you could actually do it? I've done some pretty gnarly wound care... Is there anything about it that you think would trip you up? smells? I think children would be my breaking point. I'd like to be on the list for adults only, but I don't think it works that way.

Nah on smells and stuff I’d think the worst like you said would be children. I am a new parent (well now a 10 month old) and it put me at a different mind set with children.

I don’t know if I could do it. Maybe maybe not lol

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SafetyNurse1968 has 20 years experience as a ADN, BSN, MSN, PhD and specializes in Oncology, Home Health, Patient Safety.

10 Followers; 44 Articles; 237 Posts; 14,841 Profile Views

1 hour ago, Golden_RN said:

Absolutely fascinating. Thank you for this.  I think I could do it.

Golden-RN, you are brave, so very brave. Thanks so much for reading and commenting - I really appreciate it.

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