Dealing with Patient Deaths

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Who You’ll Hear

Kati Kleber, MSN RN – Nurse educator, former cardiac med-surg/stepdown and neurocritical care nurse, author, and speaker.

Elizabeth Mills, BSN RN CCRN – highly experienced neurocritical care nurse, current Stroke Navigator for a Primary Stroke Center.

Educate
- It’s really upsetting for loved ones, prepare them for what they’ll see
  - Suctioning, snoring, pain meds, gurgling
Communicate the medications you’re giving, what you’re doing before you do it
- Talk to the patient as if they can hear, even if you don’t think they can
Be careful about your wording and tone
- Don’t come into the room all peppy and happy
- Words matter
  - Do not say, “withdraw of care” – rather, “withdraw of life support”
  - People may think that if the focus shifts from survival that they will receive less time and care from the staff
Don’t tell the family when/time frame, because you honestly don’t know and don’t want to fail to meet expectations

Know your institution’s policies and procedures
Know when to notify the organ procurement team
Know the specific needed paperwork (release of body)
Remove restraints if appropriate
Know post-mortem care procedures
Know if the patient will be sent to the medical examiner because that will impact your post mortem care

Ask about religious or spiritual preferences, as well as culture to ensure they are prioritized and observed appropriately
Allow silence
Don’t rush out of the room
Make sure there are lots of tissues
Utilize other support systems – chaplains (who are usually trained to be with people in crisis, whose focus is to provide spiritual support and not convert people to specific religions), child life specialists, family supports
Transfer to a larger room, if possible

“Palliative care is whole-person care that relieves symptoms of a disease or disorder, whether or not it can be cured. Hospice is a specific type of palliative care for people who likely have 6 months or less to live. In other words, hospice care is always palliative, but not all palliative care is hospice care.” (Source)
Can help put the big picture together

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