How To Take Care Of The Body After Death.
The doctor must be notified immediately that a patient has ceased to breath and if the relatives of the patient is not present, certain effort should be made to inform them at once. The exact time of death should be taken note of and nothing should be done to the body until the doctor has certified that death has occurred.
Then if the relatives are present, they may remain alone at the bedside for a few minutes if they wish to.
The relatives may then be taken to the waiting room and can be offered tea or some refreshment. The nurse should know instinctively how to look after the bereaved. At a suitable opportunity, the nurse should enquire what the relatives wishes are regarding any jewelry such as the wedding ring of the patient. Dentures are usually left in position but again the nurse should find out the relatives wishes.
Immediately the patient dies, the eyes should be gently closed and the face covered either with a clean laundered sheet. Ensure that the bed is completely screened and pull down the blinds in the vicinity. Remove all equipment and apparatus such as oxygen cylinders, air rings, bed cradles and all the pillows except one.
Unless there is a contraindication on religious grounds; take to the bedside a small tray containing the following:
- A gallipot containing white wool
- A bowl of warm water
- A three inch wide bandage
- A soiled linen receptacle
Strip the bed and place the linen and blankets in the receptacle. Leave the body covered by the top sheet. Sometimes it may be necessary to leave the draw sheet.
Lay the body flat and straight, taking care to straighten the fingers. Remove any hairpins or decorations from the hair, tidy the hair and lay the head gently on the pillow. Bandage the jaw with a four-tailed bandage to keep it from sagging.
Prepare two small pieces of cotton wool about 2cm in diameter, moisten them in the warm water and closing the eyelids, place the moist cotton wool over the lids. This ensures that the eyes remain closed. If the head is verminous, the hair must be combed with a fine toothcomb and all pediculi removed and placed in swabs which should be burned immediately. Make sure that the limbs are quite straight. The feet can be prevented from falling over by tying them together with a bandage or placing firmly rolled up towels at the outer aspect of the foot.
In some places, it is the practice for funeral undertakers (morticians) to prepare the body for burial or cremation. If so, the relatives may ask to see the body before it is moved to the mortuary. Before taking them to the bedside, the nurse should try to prepare them as well as she can for the ordeal, especially if there is gross distortion of appearance; example: following road accident.
If further care is to be given in the ward, the nurse places the articles necessary for the last orifices on a trolley:
- A basin with warm water
- Washing flannels
- Soap and nail-brush in a dish
- Scissors, two pairs of dressing forceps and nail scissors in a receiver. These instruments should be kept for this purpose only.
- A gallipot with cotton wool and brown wool. This is used for packing orifices.
- Clean personal linen or a mortuary gown and a mortuary sheet.
- A bin for soiled dressings.
- Receptacle for soiled linen.
Take the trolley to the bedside and carry out the last orifices as quickly and quietly as possible to avoid distress to the other patient. Remove the bandage from the jaw, the pads of wool from the eyes and the night gown. Proceed to wash the body as for a bed bath. Swab the nose, the eyes and the mouth with moist pieces of cotton wool; the nails are cut and scrubbed if necessary.
The dentures should be cleaned and returned, if that is the wish of the relatives. When washing the back, the anus and vagina are packed with wool, using dressing forceps. The nose and mouth may be packed lightly with little rolls of white wool, care being taken not to distort the features. If the patient has had an operation performed and the dressing was in position, remove the binder or bandage and the dressing; then place them in the soiled dressing bin. If a drain was in situ, remove this, but not any stitches or clips which may be present.
The drain orifice may be packed with non absorbent wool, a clean dressing applied and held in position with elastoplast. The hair is combed in the normal style. The body is now rolled over and the bottom linen rolled up to the back and the mortuary sheet placed on the bed. The body is then rolled back, the soiled linen removed and the mortuary sheet pulled through.
The shroud is now put on and the ankles and knees may be tied together with firm calico bandages. Before folding the mortuary sheet round the body ensure that there is no leakage from any orifice and tie a mortuary card to the wrist. The name should be written on the card, the time of death and the ward number. The mortuary sheet is then folded over the body, the top part folded over to cover the face and the bottom part turned up to cover the feet.
The loose side of the sheet can be held in position by safety pins. Another label may be pinned to the mortuary sheet. The body should be placed on a stretcher as soon as possible, covered with a pall, then removed to the mortuary.
Every article which belonged to the deceased, no matter how small and insignificant it may seem to the nurse, should be collected and listed. Particular care should be taken of money, documents and any other valuables. These articles should be handed over to the relatives as soon as possible and a receipt obtained.
The nurse should advise the relatives on the procedure to be followed after death has occurred, for example, the nurse must tell the relatives to return for the death certificate and remind them that the death must be registered. Also, if the doctor has expressed a wish for permission to carry out a post-mortem examination, it must be gained from the relatives and the doctor will ask them to sign a form to this effect.
- All dressings and used swabs should be burned.
- All linen and blankets are sent to the laundry.
- The pillows and mattress are sent to be disinfected by autoclaving or fumigation if necessary.
- All equipment such as bedstead, locker etc, is disinfected as described.
- The screens should remain round the bed until all disinfection has been completed and the bed remade as a simple bed.