End Point: Post Mortem Care
Nurse Theo stands there observing the scene around him. His fellow nurses busy cleaning things up in the area, folks weeping in the corner, the doctor holding an ECG paper of flat tracings and a pale and still body in the middle of all the happenings. This is just a typical scene in the clinical setting, however, every time it happens, it still disheartens Nurse Theo. Emergency medications have been administered, procedures performed, all efforts have been exerted, yet to no use. A patient has been declared dead.
Like reading numerous books, we nurses experience many facets of life: from sickness to health, joyous moments to the depressing ones, from womb to tomb. Who would ever deny that feeling of rejoice upon hearing the first cry of a newborn? Or that sigh of relief and utter joy upon hearing that your patient is now ordered for discharge? Nursing is full of moments worth cherished for, yeah?
However, we also get to experience all the unpleasant things. We get to encounter patients close to giving up, folks crying in the hallways and patients taking their last breath of life.
In all those aspects, nurses play several roles. Not only do we render therapeutic nursing care to those living, but even after death, we still have the responsibility to deliver the appropriate care to our patients.
Care after Death: Post Mortem Care
Basically, post mortem care is defined as providing physical care of the body of a patient who has expired, to prepare the body for viewing by the family and to prepare the body for transfer to the mortuary. In performing post mortem care, there are several guidelines that need to be considered:
- Post mortem care must not be performed until the patient has been pronounced dead by the doctor.
- Wash and dry your hands thoroughly before beginning procedure. Gather all needed equipment and supplies to perform the procedure and take to the patient’s room.
- The cultural, religious, and age-related needs of the deceased patient and the family/significant others must be considered whenever delivering post-mortem care. Should a patient of the Catholic faith die without seeing a priest, the Staff/Charge Nurse must summon a priest to the room before releasing the deceased resident to the mortuary. Post mortem care is also not to be done on patients of Jewish faith, instead a representative of the Chevra Kadisha, Jewish Burial Society, will come and perform the service. Wait for this representative. The family or the Staff/Charge Nurse will inform the society of the death.
- Additional assistance may be obtained as necessary. If family members or visitors are present, ask them to wait outside the room until the procedure has been completed. If possible, the patient’s roommate (if any) should be assisted out of the room.
- Close the door to the room and lower the head of the bed.
- Put on gloves. Then remove all pillows except one, which you will place under the resident’s head.
- Treat the deceased patient with respect and dignity throughout the procedure.
- Place the deceased patient in the supine position then disconnect all tubes, IV lines, catheters, etc. otherwise instructed
- Straighten the arms and legs of the patient gently so as to avoid bruising the skin.
- If the patient’s eyes are open, close them by gently taking the eyelashes and pulling the eyelids down over the eyes. However, while doing such, avoid touching the eyelids as this may cause an unnatural appearance
- Bathe and cleanse the body while keeping the resident’s body covered as much as possible.
- Close the resident’s mouth by cupping your hand under the resident’s chin and applying light pressure. If with dentures, reinsert them and if the mouth will not stay closed, place a rolled towel under the chin.
- Comb the resident’s hair as necessary, remove all soiled dressings and bandages and discard into designated containers.
- Cover all wounds with clean dressings with the use of an adhesive tape to hold them in place.
- Remove all jewelry from the deceased resident, unless otherwise instructed. The patient’s ID band/bracelet must stay in place. If jewelry cannot be removed, or the resident’s family requests that the jewelry remain on the patient, the nurse must record this information in the patient’s medical record.
- Belongings of the patient must be packed and given to the family. If the patient’s family cannot pick up the patient’s personal belongings at time of death, store such items in a safe place until the family members can do so.
- Cover the resident with a sheet. Place the sheet up over the chest for family viewing. Position the resident’s arms to their sides.
- Remove all post mortem care equipment, supplies, and trash from room.
- Pour the bathwater and all other used liquids down the toilet and flush.
- Invite the family back into the room and leave them alone with the resident. After they leave, remain with the deceased until the mortuary arrives; close all resident room doors and clear hallways before moving the resident to the transportation area, providing privacy.
- Handle the deceased patient carefully so as to prevent distortion, discoloration, or other harm to the body
- The deceased patient’s body must not be left alone, instead, remain with the patient until the deceased is released to the mortuary
- Strip the bed and discard all laundry and linen into the soiled laundry hamper. Then clean, disinfect, and return all reusable equipment to designated storage areas.
- Return the cubicle curtain to the open position
- Wash and dry your hands thoroughly.
- Document the event including: Date and time care was given; Name and title of the individual(s) performing the procedure; What was done with the patient’s personal effects, especially jewelry and dentures.; Signature and title of the person recording the data
- Report any other information in accordance with facility policy and professional standards of conduct.