Your opinion please

[AngelKissed857, BSN, RN]

Last night I spent the evening in a local ER regional trauma center) with a dear friend whose husband had just passed away. He collapsed at home, 911 called, but too late. EMTs did everything they could. Anyway, my friend called and asked me to come sit with her. They were still in a trauma bay, he was partially covered with a sheet, was still intubated, and his face was covered in blood.

Here's my question, do you generally clean a patient up a bit before bringing the family in? It gets busy , I know, but it was distressing for the daughter to see her dad that way. Just wondering what you do in your hospital.

[BecomingNursey]

We clean the patient up and make them look as normal as possible and I explain to the family what to expect their family member to look like when they see them on the way back to the room.

I'm not telling you it's going to be easy, I'm telling you it's going to be worth it.

Author: Art Williams

[MunoRN, RN]

If there's a chance it's a coroner's case then no tubes or lines can be removed until cleared by the M.E., the blood certainly could have been given at least a quick wipe down. If not an M.E. case then we "make 'em like God made 'em" - no tubes, lines, etc. It can get busy in the ER but de-lining and a quick clean up can be done in two or three minutes.

[NOADLS]

Depends on who I delegate the task to. Sometimes they don't get it done before the family arrives.

[Gooselady, BSN, RN]

I used to work oncology and we made every effort to make the deceased person look clean, keep their mouth from gaping, make them look as if they are peaceful as possible. We didn't have an awful lot of coroner's cases where we left the lines in, and it would be hard to see your deceased loved one with an endotracheal tube jutting from their mouth . . . but dang people, at least wash their poor face. Think about this being the last images they'll have of their loved one.

My grandmother who has since passed on was upset for years that she was brought in to see Grandpa after he died, with his mouth gaping open and tongue sticking out, dried foam around his mouth and 'brown stuff' (her words). It takes two seconds to wash a face and prop the chin so the mouth closes. She was terribly haunted by that last image she had of him after 65 years of marriage.

I know we get busy or even forget, but I hope most of the time nurses can remember this small but important detail.

One time me and the CNA's were 'bagging' (horrible term) a deceased patient, zipped and everything, when suddenly at the door some more of his family shows up! Very quickly, we unzipped to mid chest, put the pillow behind his head, covered him with a clean sheet and blanket and tucked evidence of the shroud away. It took twenty seconds (well, I didn't time it ). No time at all, let's say.

This is just one of those times in life that I don't buy that we nurses can't go the extra few INCHES, for the sake of the grieving relatives. It's not hard to put ourselves in their place, because we will be or have been in their shoes, and know how vulnerable a place that is.

[Paws2people]

Depends on who I delegate the task to. Sometimes they don't get it done before the family arrives.

And you, of course, would not step in to HELP get the "task" done QUICKER?

Then the deceased would be prepared properly in a timely matter for their grieving family to view. It's all about teamwork

[jadelpn, LPN, EMT-B]

There are some families that are observers of the entire code process. So they are present from the moment that the patient arrives. If the family is not in the room for the code, we make every effort to clean the patient up as we best can. Otherwise, families will often want a few minutes to sit with the patient as is. We have done a bunch of stuff to their loved one that some families find "invasive" so they would like us to let the patient be for a little bit to attempt to have the family regroup and stop doing "stuff" to their loved one.

For others, it is the reality that all the tubes and such was an effort to keep their loved one alive. It helps them start the process of "this really occurred, and they did everything feasible"

Usually with coroners cases they do not allow anyone into the room until the body is "cleared", even medical personnel, once the code has been called. Then, they want to take the body pretty swiftly once the tubes and wires are removed. So those extra minutes from when the body is cleared to when it is ready to be moved can be precious to a family member. Perhaps this was the case here.

I am sorry for the loss.

[Farawyn]

And you, of course, would not step in to HELP get the "task" done QUICKER?

Now, this is just a silly question to ask NOADLS.

[loriangel14, RN]

Any unexpected death would be a coroners case. Nothing can be touched.

[Rose_Queen, BSN, MSN, RN]

If he was a coroner's case or they had yet to receive confirmation that he wasn't, then nothing as far as lines/tubes can be touched. The blood could have been wiped up a bit, but sometimes the patient continues to bleed even after death, especially if there were some traumatic wounds. I remember a GSW where the patient pretty much started to bleed out of every orifice- and it didn't stop after we called it. We did what we could to clean up, suctioned out the mouth, tucked some gauze in the mouth around the tube, but unfortunately, he still continued to ooze when the family saw him. All we can do is our best.

[sistrmoon, BSN, RN]

I don't work ER but I work Onc and deal with a lot of patient deaths. We leave central lines in as they are sometimes used for embalming, but remove peripheral IVs, foleys, etc. We clean the patient up, position them for family viewing. When that's done they are tagged and bagged for morgue transport.

[Paws2people]

Now, this is just a silly question to ask NOADLS.

Yup, I couldn't resist.