time of death

[annmarierichard]

Hi to allnurses:

I am writing in request for nursing notes professionally written for time of death statis... I usually write: R;0, P;0, 0 audible BP: time of death 1014. Is there a professional way of writing this in the nursing notes? Thanks for any suggestions & thanks for the help

Graciously

Annmarierichard

[Silverdragon102, BSN]

Moved to the general nursing discussion forum

I just post time of death and that no apical pulse or respirations noted for 2 mins. A lot will depend if the facility has their own definition on how you write

[leslie :-D]

if i wasn't present: pt found w/o respirations, pulses, and bp at ______am/pm.

skin warm/cool to touch. no rigor mortis present. md and pt's spouse/dtr/poa notified and aware.

if i am present: pt noted with cheyne-stokes respirations x 45 mins; non-reactive to writer's/family's voices; extremities purple and mottled. at 4:15 am, pt noted to have apnea x 60 secs, over 1/2 hr., when respirations completely ceased at 4:45am. no pulses, no bp, pupils fixed/non-reactive. md notified...etc.

leslie

[Asystole RN]

First consult your facility policy. If no policy exists then consult your Board of Nursing, different states have different requirements for nurses to call th time of death.

My state wants the following to be assessed and charted; no respers, unable to auscultate or palpate pulse, hypothermia, livor mortis, no pupilary response, practitioner/family notified.

[DLS_PMHNP, MSN, RN, NP]

if i wasn't present: pt found w/o respirations, pulses, and bp at ______am/pm.

skin warm/cool to touch. no rigor mortis present. md and pt's spouse/dtr/poa notified and aware.

if i am present: pt noted with cheyne-stokes respirations x 45 mins; non-reactive to writer's/family's voices; extremities purple and mottled. at 4:15 am, pt noted to have apnea x 60 secs, over 1/2 hr., when respirations completely ceased at 4:45am. no pulses, no bp, pupils fixed/non-reactive. md notified...etc.

leslie

It always made me nervous when I was a new hospice RN pronouncing death (I worked in an inpt facility). Esp. when apnea lasted >1 min, then pt would start breathing again.

the first time I observed the 'funeral man' put a body on the stretcher and pulled the lap belt across, the "whoosh" sound coming out of the lungs was enough to almost make me pass out.

I'm better with it now. But it certainly isn't easy. And never will be.

[loriangel14, RN]

We write " patient VSA @ ____"

[caliotter3]

Does VSA mean vital signs absent?

[leslie :-D]

It always made me nervous when I was a new hospice RN pronouncing death (I worked in an inpt facility). Esp. when apnea lasted >1 min, then pt would start breathing again.

the first time I observed the 'funeral man' put a body on the stretcher and pulled the lap belt across, the "whoosh" sound coming out of the lungs was enough to almost make me pass out.

I'm better with it now. But it certainly isn't easy. And never will be.

i so understand, di.

one time i pronounced a pt and told her dtr, who was present.

well, guess what?

pt wasn't dead.

the perceived death, was a loooooong period of apnea...

and when she started breathing again, i jumped through the ceiling.

i ran out and got the nm- the nm said "oh yeah, she's gone"...

and i whispered back, "don't be so sure".

but this time, she really was...as i still remained standing behind the nm, holding onto her shirt.

awakening from the dead, is an event no one ever gets used to.:uhoh21:

leslie

[VivaLasViejas, ASN, RN]

Oh my gosh, that's scared the bejeebers out of me more than once! It's also kind of embarrassing when you pronounce with the family and/or other staff in the room, and suddenly the patient takes a huge agonal breath......... Never had one "come back" from the dead, though. Whew!

[arabstarRN]

I know when my father in law passed, he had a pacemaker and although his breathing was Cheyene Stokes for a long time, and then he become agonal and was breathing 2-3 times per minute and then eventually he was breathing once per minute until he took his last breath, but the nurse couldn't call his time of death 1601 because his pacemaker was still firing and she needed a strip that showed no heart activity. She couldn't get the pacemaker to deactivate with the magnet and it took her until 1614 to finally get her strip needed to confirm death, even though she heard no breath sounds and there was no pulse. I helped with post mortem care on him, and being a new grad had never done this. He had a trach and the nurse and the respiratory therapist warned me about what may happen when they remove his trach, and sure enough, lots of secretions started coming out the hole. Glad they prepared me first... it's that kind of stuff they don't teach well nursing school... in fact we never had any discussion on postmortem care...

I am sad and sorry he is gone, but I am thankful to him that he gave me the opportunities to learn more to help my career, and I can only hope that he knows that, I tried to tell him many times that I was grateful he allowed me to be involved in his care.

[loriangel14, RN]

Does VSA mean vital signs absent?

Yes it does.

[MMARN, BSN, RN]

According to our policy, we chart final v/s, temp/look of skin, pupil reaction, resps, pulses, notification of MD/family/AOD, and who pronounced pt.