What are your basic procedures post-mortum?

florry · Jan 18, 2004

Dear Wndy!

I Know the procedure in Norway, but I dont think it differs too much from US.

After a MD has stated the death, we usulally wait 2 hours. You have the time to prepeare the realtives and doing paperwork.

When we are taking care of the dead person, I wash, shave him/her, tamponate he rectum and lady parts, changes the compresses, remove tubes etc. Replace the teeth. I Usually aske the relative if their have preferences in clothing (something personal). Jewelry is taken off, the weddingring is a very important symbol for the relatives. One of the toes has a ID connected with death time written onl

The head or chin is often falling down, and you can use a chin holder, so it look nicer and the mouth get closed.

After using sheets around the pt. in a special way, I put the cleaned pillow down by the feet. Then his featherbed (I am not sure if its the same in US as in Norway), witch is cleaned and made the bed as it was a new one and unused, or look like this. If this procedure is done nice and good, no one will see that its a bed with a dead pt. If its difficult and expected fex. in a nursing home, many old pt have discovered the situation. Then I sit down with them for a while, explain the situation and why I am closing the doors for a while. I have never had negative reaction in doing this this way. In a double room I will prefer to move the pt to the baath room, and of course using some time to take care of the other person in the room- he or she has their mourning. We allways find a room, if the institution dont have a special chapel or cold room to bring the pt. in to, and open the windows, if not air conditionnig.

I dont know if it was a good answer, but its our procedure before the funeralcompany come. If the relatives want to see them, we allways find time for that.

If you have further questions, please feel free to write.

From

Havin' A Party!, ASN, RN · Jan 18, 2004

Thanks, Florry!

Like the special and caring treatment you provide to everyone.

ernurse2244 · Jan 18, 2004

How we treat the patient depends on whether there is to be an autopsy or not. If autopsy, very little is done...lines, tubes, etc are left inplace. Otherwise, they are bathed, dressed in a clean hospital gown and covered with a sheet. This is done in a semi-private area with the curtains closed. If the family wants to come back into the room, I cover the patient to their upper chest with the sheet, leave the arms above the covers so they can hold the patient's hand (which they frequently want to do). I try to make the patient look "comfortable", ie be sure the chin is supported, they are flat on their back, etc. If I have had to leave tubes inplace, I explain that to the family before they come in so they will be prepared to see it (do that with live patients too...families are frightened of all the wires and tubes we use!). The hospital I currently work in usually leaves the patient in the bed they die in until the undertaker arrives. In other hospitals, when the patient has to be transported to another area, there was a special stretcher that had a "box" the patient was placed in below the surface of the stretcher, with a sheet over the top, looked like an empty stretcher.

suzanne4, RN · Jan 18, 2004

In the US, you place the patient in a morgue shroud and they are transferred to the hopsital morgue until picked up by the funeral home. We normally do not place anything in the rectum or lady parts. tubes can be reomoved only if it is not going to be a coroner or medical examiner case. We do not replace the dentures in the deceased patient's mouth but send them with the patient to the funeral home. If the family does not want the patient to be buried with the wedding band we try to remove it as quickly as possible before any swelling develops in the hands.

Jaw support can be used, but not always necessary.

In some regions the funeral home may pick up the patient directly in the room but I haven't seen that in awhile. If the deceased was in a semi-private room, the drapes are pulled while post-mortum care is done. Most hospitals have a cart that has a white covering over, known as the "morgue cart" which is used to transport the patient. Some hospitals close the doors to all of the patients rooms to move the body down the hall.

Many ERs take the patient down the hall, usually from the trauma room, with a pillow under the head, and the sheet not over the head, so that it looks like you are just transferring a patient to a back room where post-mortum care can be completed, etc and not alarm the rest of the patients and visitors.

jenac · Jan 18, 2004

In LTC, our procedures are very similar-except we don't transport the deceseased anywhere ourselves. In a semi-private room- we pull the curtain around the bed, and bath the body, removing all tubes (NG, IV, Foley...). We put an Attend (incontinant brief) on the resident. We keep the HOB flat, no pillow underneath their head (or the flatest one we can find), and use a rolled towel under the chin to keep the jaw shut if needed. The bed is made with the sheet folded down under the chin. If the resident has dentures, they are sent with the body.All equiptment like O2 concentrators and IV poles are removed from the room. I always have two girls do the care togther (moral support), preferrably atleast one has post-mortem care (if not, I generally step in as the second), and offer a short break afterwards.

Generally, the room-mate is already aware that the resident has passed on- but I do tell them, and we try take them out of the room so that they don't have to deal with the family or the mortician. I usually ask the family if they want me to call the funeral home immediately-or if they want me to wait- but if it's a particularly difficult death to deal with, I will call right away. The family usually leaves when they come to get the body. It can be one or several hours. When the mortician arrives and the body is transported out, we try to go for the nearest door and avoid other residents-which can be difficult. Everybody seems to know when someone dies in LTC, but we do try to avoid as much as we can.

Hospise is diffferent- we have to call the hospise nurse before we do anything-they come in and pronounce, and direct us on when to call the moritician. They also call in the family, if not there already. We still do the post-mortem care, and charting, but Hospise directs everything else.

EyesForward · Jan 18, 2004

Thank you everybody, for your replies. It helped me have an 'advance picture' of what to expect as I come face to face with this situation in the near future.

florry · Jan 18, 2004

Dear Wendy!

I want to tell you a story that I have experienced after an old lady died: And IT IS NOT FOR BRAG:

Her daughter came to me a week after her dead:

She said: I want to thank you, not neccecerelly for the ting you said to us (her and her husband), but for your caring, compassion, listening - for the way you was.

I noticed that my tears come, and we gave each one a hug. That situation learned me A LOT about how vulnerrable the human being is.

You will be a great nurse: since you are wondering about this issue even as a first grade student! (I am a nurseeducator,too)

Love from Florry

EyesForward · Jan 19, 2004

Florry, smiled and felt good about what you said. Thank you for your last message.

Cryssi · Jan 19, 2004

Hi, I hope this isn't too dumb a question to ask, but seeing as I am not a nurse (though that is one of my dreams), why is the orifice and lady parts inserted with a tampon or why are depends used? Does the body release fluids/excrement upon death? Just curious.

Cryssi

florry · Jan 19, 2004

Yes, its not an odd question.

After the person has died, there is no longer blood fluied, repiration and the natural bacteria we have in our body will start to degenerate, or another word wich is a little scary; rotten. In any crime-case they can find out how long the dead pt. has been dead, because different animal seeim to eat rotten meat, depend on how long the body has bean dead.

After the dead, we prevent fluid/bacteria/pus coming out with tamponating the rectum and lady parts. The funeral company has learned me that its VERY important to aware fluid leccage in the coffin. You may use a dieper too. Some relatives want to take care and do the last procedure together with a nursel . I ofen drop the tamponade when they are with us, but du it after, or use a diaper. It very emotionally thing to do, espec. with your loved one witch is dead. So I do the procedure VERY carefull, with dignity and of course respect, depite the relatives are doing this with me, or not.

Hope I gave you an answer, - feel free to ask more about things you wonder about.

Love from Florry

florry · Jan 19, 2004

The Reader!

I apologize all the wrong written word, the grammar and my bad English! This is the way I can practice, and hope you understand the main issue.