The declaration of a patient’s death must be timely and respectful

Over the past few years, the authority of an RN or APRN to declare a patient’s death has increased. At least 20 states, including Ohio, New York, California, and Florida, have passed laws allowing RNs and/or APRNs. However, regulations vary and the variances relate to many aspects, similar to the place of death (e.g., hospital, nursing home, home), who the RN or APRN must notify before declaring a patient dead (e.g., health worker, health worker), requirement, that the RN or APRN will look after the patient and whether the RN or APRN can complete and sign the death certificate. It goes without saying that declaring an individual’s death is a serious responsibility and should be done with grace, respect and look after the family of the deceased. The duty must even be consistent with the legal and ethical mandates of the RN or APRN. Sometimes such mandates aren’t at all times followed or it could be difficult to find out what’s required. As an example, a reader once shared her unlucky experience of her father-in-law’s death at home. The patient was under hospice care, and when he died, the family immediately called a hospice nurse. The nurse told the family that she couldn’t get home for 4 to 5 hours to substantiate the death. As the RN, she desired to announce her father-in-law’s death, but she had no legal authority to accomplish that. Understandably, this example was terrifying and really stressful for your complete family, including the RN. In one other case, a reader who was a house manager reported to work and was told that a DNR patient had died several hours earlier and the first physician was out of town. The alternative doctor was unable to come back to the power to make an announcement. Per facility policy, the RN contacted the emergency department physician, but he, too, declined to supply an announcement because he was too busy. By now the patient had been dead for at the least five hours and the family remained within the patient’s room. After requesting assistance from the chief of staff, with no results, the RN pronounced the patient dead and documented her assessment within the medical records. The RN was suspended and charged with practicing medicine and not using a license. The next item on the agenda was a gathering with the director of nursing. In each cases, there have been policies, procedures and regulations in place to enable the death to be declared in a timely manner. But that did not occur. Both RNs showed courage and ethics of their situations: one realized her helplessness and the opposite took motion. If you’ve gotten the authority to adjudicate death, make sure to familiarize yourself with the necessities of that duty and maintain those boundaries not only within the adjudication process itself, but in addition within the timely performance of your duties. PLEASE NOTE: Nancy Brent’s posts are for educational purposes only and shouldn’t be construed as specific legal or other advice.

Develop your nursing skills with these popular CE topics

(25 contact hours) Written and rigorously peer-reviewed by pharmacists and advanced practice nurses, this course covers a big selection of conditions and related medications. Chapter topics include hypertension, diuretics, gastrointestinal tract, intensive care, sexually transmitted diseases, asthma, oncology, non-opioid pain medications, diabetes, weight reduction, mental health conditions and more. The chapters include guidance on APNs to help physicians in prescribing medications. This course will help APNs meet the brand new ANCC requirement of 25 hours of pharmacology contact for recertification. (1 contact hour) Nurses are called to supply care. They apply evidence-based practice, clinical knowledge and demanding considering with compassion and empathy. Join this webinar to learn the difference between empathy and compassion, and how one can recharge and maintain yourself to raised care on your patients. (1 contact hour) The National Pressure Ulcer Advisory Panel modified its descriptive language in 2016, starting from pressure ulcers to pressure injuries. Because skin can look very different depending on an individual’s skin tone, it will be significant to strengthen assessment skills with suggestions that may help prevent deeper injuries from being “missed.”