What's Involved in Post-Mortem Care?

jmgrn65, RN · May 15, 2008

Hi I am a nursing student...I heard today that we as nurses have to perform a death wash on a dead patient... I sthis true...I am okay with all other aspects of nursing...I am stil a student but I am not so sure if I am able to cope with a deathwash.. I have not seen anyone die yet and I am scared I wil be unable to perform such an act..does that mean I am not cut out to be a nurse because bathing someone after death scares me...I have never even seen a dead body other then 2 people my grandfather and my one uncle..How do I know if I wil be a good nurse if I am unable to face dead...What if Icannot do a death wash wil the hospital force me to do it...I guess I am scared cos I do not know what it intails...What hapens when some one dies...Plese help me I donot want to be scared..I would like to act in the best intrest of my patient but Im scared...

No you do not have to do a death wash. I think they used but not anymore. If they have soiled yes you will have to clean them up.

It's ok to be scared, I think most nurses are at first. Don't sweat it you won't be alone.

pinkiepie_RN · May 15, 2008

Hi I am a nursing student...I heard today that we as nurses have to perform a death wash on a dead patient... I sthis true...I am okay with all other aspects of nursing...I am stil a student but I am not so sure if I am able to cope with a deathwash.. I have not seen anyone die yet and I am scared I wil be unable to perform such an act..does that mean I am not cut out to be a nurse because bathing someone after death scares me...I have never even seen a dead body other then 2 people my grandfather and my one uncle..How do I know if I wil be a good nurse if I am unable to face dead...What if Icannot do a death wash wil the hospital force me to do it...I guess I am scared cos I do not know what it intails...What hapens when some one dies...Plese help me I donot want to be scared..I would like to act in the best intrest of my patient but Im scared...

Everyone eventually dies. It's not a pretty part of life, but it's intense and meaningful for what it's worth. In my nursing skills class last semester they taught us how to do peri-mortem care. They also taught us that it's a completely gut wrenching experience the first time or many times after if death is not a common occurrence on your unit. You may not want to go into ICU or ED if dead people scare you, but I don't think there's anything to be scared of. You make sure to give the dead patient the same level of care as you would a living patient and be there to support the family if they're willing to accept such support. Many of my instructors said that they didn't care for a dead patient until after graduation and there's some units where patients rarely die: well health clinics, doctors' offices, employee heath. Death is a part of all nursing because you never know whether a patient will live or die sometimes and it's the chance we take each day. Don't let the fear of dead people stop you from getting into nursing. I'm sure you're not the only person who feels this way and it's a very compassionate way to feel. I've frankly never had a dead patient yet (or been close to anyone in my family that's died) and I'm sure I'll be an emotional mess when it happens, but I hope I'll have a supportive unit and manager to be there for me and I'll seek help dealing with grief if and when it happens.

As for the "death wash", what I learned is that it's basically the same thing as AM care or a bed bath...you wash the patient from head to toe. There are some special tasks involved such as removing jewelry and positioning so the patient does not exhibit signs of periorbital bleeding, but I'm sure you could get a co-worker to help you out the first or many times if it's something you're uncomfortable with. You would also most likely be responsible for helping the family initially cope with the mortality of their loved one, but I'm sure a social worker and psychologist would probably help with this as well.

Hope this helps!

allnurses Guide · May 15, 2008

When I first saw my dead person I was 18 years old and a student nurse, it was such a shock. The qualified nurse left me for a moment in the room to get some towels and I stood by the door convinced that the patient was going to sit up and talk to me.

It is natural to be anxious about something you have not expereinced, it will be very different to seeing a member of your family and you will be anxious.

We do wash our deceased patients, it is something that I actually like to do for them. It is the last thing you can do for them as a nurse, I wash, do their hair and make them presentable for their family. It allows them the dignity of being clean and fresh to go where ever they are moving on to. There are some religions that will ask that the family do this but you can find that out from your clinical instructor.

If you are not comfortable at first just be in the room with the support of a qualified nurse is a start, you will get used to it and you will find your own way to deal with death of a patient.

From a personal perspective I find that it is my way of saying goodbye as thier nurse and it gives me closure to their care I suppose.

justme1972 · May 15, 2008

In all due respect...please don't call it a "death wash".

It's just a disrespectful term for post-mortem care, which all deceased patients are entitled to, if their facility requires it, unless they pass along this task to the funeral home.

november17, ASN, RN · May 15, 2008

No one is going to force you to do post-mortem care. That being said, I think you have to understand that death is a natural thing that happens to everyone at some point. While it is sad, if you look at it from the point of view that the person is being relieved of their earthly suffering (especially if the cause is a chronic painful/debilitating illness), death can actually be quite liberating. It is a bit odd doing the care, I've done it quite a few times and it's something I've never completely gotten 100% used to.

Don't think of postmortem care as a full scrubdown or anything though. You're basically trying to clean them up using a washcloth and trying to make them look as "presentable" as you can. Do a head to toe; D/Cing lines/drains (if in line with policy and an autopsy isn't going to be done), Cleaning up any body fluids, providing peri care/oral care, brushing the hair. Pack their dentures/glasses/jewelry up to send to the mortuary with their remains. The sooner you do all this, the easier it will be...trust me...Don't wait to do postmortem care, it is something that needs to be done as closely to the time of death as possible.

After the family sees them (if that is the case), then you will probably have to either shroud them or put them in a "body bag." (depends on where you work). At our facility we then take them to a room in the basement and the body is placed in a refrigerator until the funeral people can come and pick up the remains.

I don't think I've run into any two people that have needed the same amount of postmortem care. Some people pass away "cleanly" and don't really need much done, others need quite a bit of it. It really depends on the circumstances.

Home Health Columnist / Guide · May 15, 2008

Changed the title to reflect posters concerns....

One of the things I've expressed to students, new grads and my sons is that you do things out of respect and love for individuals.

Providing incontinece care for adults is giving back assistance that parents, grandparents, babysitters provided to us as infants. Caring for a person that just died is another way of caring and final comfort act for families to see their loved one too,

First time I learned to ride a bike was scarry too and took me 10x longer than usual. Support of experienced staff and education should help you overcome many uneasy moments in becoming a nurse. All is part of the circle of life.

Post Mortum Care Procedure

Daytonite, BSN, RN · May 16, 2008

bullakey13. . .i've been an rn for over 30 years. postmortem care did not consist of bathing the person unless they needed cleaning up for some very good reason. sometimes we did a spot cleaning with a damp washcloth if the patient had soiled himself with bm. if they were a coroner's case, the body was to be left untouched and all tubes left intact although the lines connected to them were removed. for all others, the limbs were straightened, dentures put in and the body wrapped in a special plastic shroud. this is to contain any fluids that come out of the body orifices at a later time during movement or relaxation of the body musculature. then the body was moved to the morgue of the hospital which was just a huge walk-in refrigerator where it waited to be picked up by a funeral home or the coroner's office if it was a coroner's case. refrigeration slows the decomposition process.

you might want to search the hospital policy and procedure links that are on the sticky thread: https://allnurses.com/forums/f205/health-assessment-resources-techniques-forms-145091.html - health assessment resources, techniques, and forms (in nursing student assistance forum) to see if there is a postmortem care procedure in there. i don't think you'll find a bath as part of the procedure anymore.

just a fyi, i got to see an embalming some years ago and the last thing the embalmers do is wash the body and rinse it thoroughly. the body does get quite bloody and messy during the embalming because the embalmers flush most of the blood and clots from the vascular system during the embalming process. i believe that every student should see an embalming so they know what these professionals do. it also gives you the rationale behind why you need to position the arms and legs and put the dentures in before rigor mortis sets in. once you've seen an embalming you'll understand why the nurse bathing the patient after death isn't necessary unless it is for esthetic reasons (like cleaning up the patient before family viewing).

allnurses Guide · May 16, 2008

I was afraid of dead bodies too. I couldn't even go to my step-father's funeral.

However, the first time I did post-mortem care I had the help of an awesome CNA and that helped me tremendously.

We do wash bodies, faces, brush hair, etc.

I now consider it a privilege to do post-mortem care on a patient.

steph

Chaya, ASN, RN · May 16, 2008

The first time I did PM care was kind of unnerving. As one poster said, though, it is the last service you can perform for your patient, and also for their family. We position the patient as naturally as possible, close the eyes if possible and replace dentures before rigor sets in b/c after that it is difficult to repositon them. We seldom do a full wash; just spot- wash anything soiled and place a pad under the buttocks. We then position and bind the hands together over the lap, place an identification tag on the toe. A plastic shroud sheet is then wrapped around the body and ties are placed around the feet waist and neck. I have seldom felt as if the person was about to speak or move; usually for me there is a strong sense that they are no longer present. I am no longer disturbed by doing PM care, just saddened. Although I have performed PM care alone, most of us will grab another nurse or NA both for company and because it is easier to roll the body to the side for positioning the shroud with 2 people. It isn't a pleasant task but goes pretty quickly and I try to take my turn and assist when asked.

shoegalRN, RN · May 16, 2008

I've had 3 patients die on me. 2 while at work (I work as a nurse intern) and one during clinicals. On all 3, I did post mortem care, along with taking one down to the morgue (at work).

For the one during clinicals, it was 3 of us, and we unhooked the pt's IV's and removed the foley and rectal tube. We closed the pt's eyes and combed his hair, along with having to put the tag on this toe and put him in the body bag. I didnt take him to the morgue, I let the other 2 students do it since they have never experienced it before.

For the other 2 at work, I helped the RN remove the IV's as well as put in their dentures and I also straightened up their rooms. We allowed the mourning time for the family and then got them ready for the morgue.

I view death totally different than I did pre-nursing.