When a patient dies....

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I am prenursing and I keep obsessing over the responsibility that a nurse has over their patient's lives. I also worry about the legalities of when/if a patient dies...How does that work? I mean, how exactly does a RN go about ensuring they aren't blamed for the death? How or why would a facility blame an RN, if their patient was to die? I know I'm being a bit morbid but this is one of the issues that really worries me.....

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Specializes in EMS, ER, GI, PCU/Telemetry.

document, document, and document some more. always CYA.

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Specializes in Geriatrics.
document, document, and document some more. always CYA.

I AGREE !!!!! D-O-C-U-M-E-N-T !!!!!!!!!!!!!!!!!!!!

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Specializes in Adult Acute Care Medicine.

Also do thorough assessments!

A few weeks ago, I had a 43 year old pt with discharge orders. His HR was 48, so I kept monitoring before letting him leave. It hung out in the high 40's (a drop for him), so I paged the doc. An EKG was done and he ended up going to a tele bed. He was upset about this but I am SO glad that I didnt let him leave.

Of course I documented all of that :)

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Specializes in Jack of all trades, and still learning.

There are two scenarios here:

1. A person with a DNR order. You need to know the legalities and procedures about this process in your state and hospital. Assessment is still important, just the focus is different. And family involvement is of paramount importance in this situation. And there are so many mixed feelings you have yourself...

2. An unexpected death. I back up everything else that ppl have spoken about so far. Assess, act, report, document. And again, know your legal responsibilities. As a new grad you should always be liasing with your seniors. In fact, when you have concerns at any level you should be liasing with others...

I don't think you ever get used to either; but you do build coping skills...

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

This issue concerns me as well, since one of my patients unexpectedly died last month. The family members of the decedent were understandably saddened at the poor outcome and are threatening to file a lawsuit against my place of employment. I am simply worried that this incident might come back to haunt me in a few years.

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Specializes in RN- Med/surg.

not only document...but do it ASAP. It may be hard to use documentation that was put in after the fact. Don't wait...chart when you have a few minutes between cares.

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Specializes in Emergency.

I agree 100% ! Document the heck out of it. You know that everything that was done. You know that sometimes a pt dies without warning. We and the Docs are not omnipotent. We cannot predict death, nor can we always see the signs that death is immenent. As long as you document (you must protect your lisence), and are honest, even a court issue will not be a problem.

The unexpected ones are the worst. If I have time, I talk to the family.

Help them, and help yourself by your honesty.

Expect anger, animosity, etc. toward the staff. The family is dealing with a shock.

Just always keep your side of the street clean.

Amy

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Specializes in Community Health, Med-Surg, Home Health.

I worry about this as well. I have not experienced this, but I do worry. At best, make sure that you notified everyone that needs to be called, document as soon as possible. I always have a piece of paper in my pocket where I am documenting small things to chart as soon as I get a chance, using the patient's medical record number and initials.

What I worry about even more is if I would be effective during a code. I never took part in one for the year and a half I have been an LPN, but I worry about my 'data gathering' and observation skills, and intervening quickly.

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Specializes in Women's Specialty, Post-Part, Scrub(cs).

I don't have experience in a hospital setting for deaths. I would agree with all previous posts....DOCUMENT. But in a LTC, we mostly have DNRs. One instance that I have run across was most unusual. Had a resident who had stable VS on my 6a-6p shift, up for meals, alert & oriented x3. The next day, I am pulling my insulins at 6a when the 2ADON comes up looking for the DON. I knew something was wrong by the look on her face. Turns out, she went into this res room to draw blood and the res was stone-cold dead. Nite nurse had already left the building. After all the dust cleared, we look at the nurses notes, she has charted her 4a rounds. Res. took meds whole without difficulty & talked to her. It was clear to all of us that she not been dead for very long but we were there to look at her immediantly. Saving grace was that the nite nurse documented!! The facility and the nite nurse were not held accountable because of the documentation. You should have seen the nite nurse's face when she was told of the death that evening. :bugeyes:

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Specializes in Acute,Subacute,Long-term Care.
i don't have experience in a hospital setting for deaths. i would agree with all previous posts....document. but in a ltc, we mostly have dnrs. one instance that i have run across was most unusual. had a resident who had stable vs on my 6a-6p shift, up for meals, alert & oriented x3. the next day, i am pulling my insulins at 6a when the 2adon comes up looking for the don. i knew something was wrong by the look on her face. turns out, she went into this res room to draw blood and the res was stone-cold dead. nite nurse had already left the building. after all the dust cleared, we look at the nurses notes, she has charted her 4a rounds. res. took meds whole without difficulty & talked to her. it was clear to all of us that she not been dead for very long but we were there to look at her immediantly. saving grace was that the nite nurse documented!! the facility and the nite nurse were not held accountable because of the documentation. you should have seen the nite nurse's face when she was told of the death that evening. :bugeyes:

i found your post interesting. i also work in ltcc where most of the residents are dnr's. we don't normally chart on them unless something is wrong. ex. not feeling well, had fallen, started an antibiotic,monthly summaries,behavior out of the ordinary etc.

do you chart on each resident each shift?

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Specializes in Licensed Practical Nurse.
I don't have experience in a hospital setting for deaths. I would agree with all previous posts....DOCUMENT. But in a LTC, we mostly have DNRs. One instance that I have run across was most unusual. Had a resident who had stable VS on my 6a-6p shift, up for meals, alert & oriented x3. The next day, I am pulling my insulins at 6a when the 2ADON comes up looking for the DON. I knew something was wrong by the look on her face. Turns out, she went into this res room to draw blood and the res was stone-cold dead. Nite nurse had already left the building. After all the dust cleared, we look at the nurses notes, she has charted her 4a rounds. Res. took meds whole without difficulty & talked to her. It was clear to all of us that she not been dead for very long but we were there to look at her immediantly. Saving grace was that the nite nurse documented!! The facility and the nite nurse were not held accountable because of the documentation. You should have seen the nite nurse's face when she was told of the death that evening. :bugeyes:

My facility has had unexpected deaths as well, usually the only documentation done is on patients on 24 hour report etc.. do you document on 40+ patients every day at your facility?

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