Nurse (hospital and other inpatient facilities)

Care provided after death

The Nurse plays a central role in coordinating care for patients and their families after death. Nursing care provided to deceased patients and their families is part of a continuum of care which may have commenced prior to death and includes:

  • Communicating with the bereaved family offering condolence and comfort,  mindful of the shock and distress that may be experienced
  • Reporting death to the doctor responsible for the patients care to ensure timely verification of death, certification of death or other actions as appropriate to the circumstances.  NB In some cases appropriately trained nursing staff can verify death.
  • Involving other members of the team as appropriate to provide support e.g. Chaplains/Faith representatives
  • Informing other members of the health and social care team who were involved in the patients care about the death
  • Caring for the deceased patient’s body after death (Last Offices) ensuring that such care is guided by health, safety and legal requirements and informed by their personal preferences, cultural, religious and spiritual values
  • Liaising with mortuary staff, porters and funeral directors involved in the sensitive and dignified removal of the deceased person from where they died, to a mortuary, pathology service, funeral director’s premises or directly home.
  • Recording fact of death and actions taken afterwards in the nursing notes

In some services nursing staff send a sympathy card, attend the funeral or visit relatives in the weeks after death.

Works Alongside

  • Relatives  to be decided
  • Hospital Doctors/GP
  • Nursing colleagues in hospital and community
  • Specialist Services who provided support to the patient  e.g. Heart Failure, Palliative Care, Renal
  • Care assistants
  • Student nurses
  • Specialist Nurse Organ Donation
  • Chaplains/Faith representatives
  • Social Workers
  • Mortuary Staff
  • Porters and Funeral directors
  • Pathology and Laboratory services
  • PSNI when acting on behalf of the Coroner
  • Governance lead
  • Community and Voluntary sector bereavement support services
  • TBC to be agreed

The standard of bereavement care is enhanced when:

  • The wishes/preferences have been identified and recorded
  • Good communication is received by the nurse about the death/imminent death of a patient especially during shift changes and handover
  • Nursing care documentation is kept up to date with information that would be relevant to when a patient dies e.g. contact details for next of kin
  • Events are recorded in the patients nursing care plan and administration systems
  • There is accurate and timely completion of certification documentation by Doctors e.g.  Medical Certificate of Cause of Death,
  • Doctors inform nursing staff when the  Coroner directs that a post mortem is required so care of the body and preservation of evidence procedures in such circumstances are followed
  • Other services involved with the patient are informed about the death
  • Information about the death is shared with other members of the team who can provide support, advice and information to the bereaved and also respond to support nursing staff in crisis situations
  • Follow up appointments are offered to relatives to explain further the cause of death, post mortem results etc.
  • Learning and development is supported and supervised for student nurses and care assistants in the provision of safe, effective and sensitive care of the deceased and their relatives Healthcare organisations have training, supervision and support systems in place for nurses
  • Services facilitate remembrance events  that nurses can attend

Standards and Guidelines

  • The Code: Standards of conduct, performance and ethics for nurses and midwives. 2008. Nursing and Midwifery Council (NMC)
  • Record Keeping: Guidance for nurses and midwives. 2009. Nursing and Midwifery Council (NMC)
  • Last Offices Procedure – Royal Marsden Hospital Manual of Clinical Nursing Procedures 8th Edition (available to access from HSC Trust intranet sites)
  • National End of Life Care Programme (2011) Guidance for staff responsible for care after death (last offices). National Nurse Consultant Group, Royal College of Nursing, Royal College of Pathologists.
  • The Northern Ireland Regional Infection Prevention and Control manual – Last Offices section.
  • HSC Trust/Employers policies and procedures in relation to death and bereavement care.