Death certification. No thanks.

17 September 2017

This event ended up in so many people taking the mick out of me for days. Possibly weeks…. It was my first (hideous) weekend on call. It was Sunday and all I wanted was my bed and a Jaffa cake (I knew I had some at home in the cupboard waiting for me!). I had a list of jobs longer than my arm. I had just been bleeped (YET AGAIN) and I recognised the number. I was on my way to that ward anyway. Rather than stop to use the phone to find out what the craic was I went straight there. It took me about 2 minutes. 

 There were a great team of nurses on that weekend, and so I asked who it was who needed me. Simultaneously two of the nurses came out of a side room looking extremely glum and the one in front held up an ECG for me. Now anyone who knows me knows that without my glasses or contact lenses in I can't see more than a foot in front of my face, and even with my glasses on I still can't see that far ahead. 

This particular ECG was a few feet from me, and as I got closer I just saw a FLAT LINE!! 'Oh my god, this doesn't happen!! Only in films!!!!' I snatched the ECG and confirmed my fears that this was an asystolic heart! Swearing occurred. I felt the adrenaline surge through my body as I frantically asked what had happened and why I was bleeped for this and not a crash call (2222) put out?? The nurses all burst out laughing at me as I grabbed gloves and charged towards the side room they had come out of.

It was the lady who was end of life and expected to die. She had a DNACPR in place and it was just an ECG that one of our Spanish nurses had done, as is custom in Spain to do an ECG to prove a lack of cardiac activity as part of the death certification. I'm not going to lie, my initial reaction was 'oh thank god- I don't have to jump on someone's chest', until moments later when the realisation hit me that this lovely lady had died alone, and her family had only just left their bedside vigil to go and get some food. 

She was very comfortable though which was comforting for us and her family. We contacted the family and they came back to sit with their relative and say their goodbyes knowing that she was no longer battling the front between life and death, a very painful process for many family members to witness. An hour or so later, at about 8pm after the family had left I went to certify the body - and it was the first time I had done this. I checked the Foundation years handbook before I went in to refresh myself on what to do and how to document it properly. 

I went into the room and the lady was turned away from me, looking peaceful. I conducted the examination (which is very strange, as it’s pretty obvious when someone is dead! But you still convince yourself that you can hear some breath sounds etc - when actually it's probably my own breathing or something!). Anyway, I am intently listening to the chest for 2 minutes like instructed to in the examination, when suddenly her chest and whole body began to move! 

I jumped about 3 feet in the air and leapt backwards towards the wall! My heart was racing and I let out a shriek!! The stupid air mattress thing hadn't been turned off! So it was still set to inflate every few minutes or so to prevent pressure sores in bed-bound patients. Honestly I almost had a cardiac arrest myself!! I did what I had to do, TURNED THE AIR MATTRESS THING OFF, and left. When I came out the nurses asked why I looked like in had seen a ghost, and I explained what happened. That was my error, and now the whole department think it's hilarious. Fabulous! A great bit of Sunday evening entertainment! Who needs Netflix eh!

Laura C

Dr Laura Cunliffe is a Hull York Medical School graduate (Class of 2017) and a foundation year 1 doctor in Grimsby hospital currently working in general surgery.

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