S1E10 – Dealing with Patient Deaths

This podcast is available on iTunes, iHeartRadio, Spotify, and Google Play

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.

What You’ll Learn

• Communication
• Practical Advice
• Palliative Care and Hospice

Communication

• 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

Practical things for you to do and know

• 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

Practical ways to support the family

• 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 and hospice

• “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

More resources

• When Your Patient Starts Crying – FreshRN Blog
• I Wish I Could Cry With You, But I Can’t – FreshRN Blog

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