Monday, August 29, 2011


Sorry for not keeping up...everything moves so FAST in orientation! I'm up to 4-5 patients, which is a full load. I'm the first one in orientation to carry a full load and get out of work on time. Which kinda scares me- am I doing something wrong to get my work done on time? God I hope not. Yesterday I worked during the Hurricane That Wasn't. The nurse in the assignment next to me and my preceptor had a patient on Comfort Measures. She died. My preceptor thought it would be a Good Learning Experience for me.
Thing is, I've seen dead people before-both in clinical and in the field. This time though, there was a difference- our MD was a brand-new intern. Didn't know the patient, since she was only admitted that morning. And, while well-meaning, he's a bit hesitant (I'm sure it will wear off). He had to certify death. He didn't know how. We had to walk him through it, and then I helped prepare the body for the morgue. The patient had had false teeth. The postmortem checklist specifies that you must replace them BEFORE sending the body to the morgue, lest rigor set in, and cause the face to be stuck without its teeth. I really REALLY didn't want to be the one to put the teeth back- after all, what if the patient rose as a zombie?!? WITH MY FINGERS IN THE MOUTH!!!!
I don't know why, but that really stuck with me. My patient could rise as a zombie, and us without a SINGLE machete on the floor!
It was only after we'd put the toe tags on, and the body IN the bag and zipped it shut that he realized he'd never done the formal LEGAL certification of death. So I went and unzipped the bag, exposing the body. He asked me not to leave the room, and help out. So i stood there, reading an instruction sheet aloud. He listened to the heart for a minute. Then the lungs. Then took the pulse.
"what do i do now?"
"You say The Words!"
"What are The Words?"
"You say 'time of death'"
"Time of Death"
"1901" And with that, the patient was formally dead. Only 1.5 hours after actually passing on. But then, life is strange like that!

I don't think I'll forget this- literally talking a doctor through someone's death. It seemed so silly, since the patient had obviously already passed on. We were the ones screwing around- they were at peace. If I were the patient, I would be giggling in heaven right about now. :-p


Anonymous said...

On my last day of clinical my patient died. My instructor gently talked me through the care.
My first month on the floor, my patient died and my preceptor talked me through.
These experiences were 30 years ago and I remain grateful for those guides; I have tried to be that gentle voice with my students and colleagues.
I am a clinical instructor and a hospice nurse now, and truly feel those two women shaped who I am today.
You made a difference--good work.

An Open Heart said...

I concur, you did make a difference and I hope the Doc remembers that, too!