If you’re not doing nursing or you’re not into healthcare then you’ve probably never heard of the phrase ‘last offices’. Well, with mixed feelings, I’d like to write about my first experience in doing last offices. To begin with, last offices means taking care of the body after a patient has passed away.
Recently, one of the patients I was taking care of passed away from metastatic breast cancer at the age of 88. I shadowed the doctor who certified her death. Being in a dark room, just me, the doctor and a breathless body…made me feel so small and useless. The doctor examined the level of conciousness (AVPU score), checked the pupils which were fixed and dilated, checked for pulse, checked for breath sounds and heart sounds with a stethoscope, checked for any pacemaker and finally certified the patient’s death in the nursing documentation.
Soon after, two healthcare assistants and me washed the body, changed the linen, covered all wounds with a waterproof dressing, covered the patient’s wedding band with tape to secure it, combed and tidied the hair, placed identity bands on the wrist and the ankle, dressed the patient and then covered the body in a sheet ready to to be sent to the morgue. All personal belongings had to be packed and documented. Lastly, I had to sign in the nursing documentation for participating in the process.
It is important for the body to be sent to the morgue and refrigerated within four hours of death in order to preserve the organs in case the patient has requested to donate their organs when they were still alive. Another thing to keep in mind is that even though the person is no more, we should still protect their privacy and dignity, and respect their last wishes and religious beliefs (if any). Never forget to inform family members when the death has occurred, which I believe is the most challenging and difficult task of all.