Heartbeat: Inside the mortuary – taking care of our patients right to the end

May 8, 2020

When many of us think of a mortuary we are filled with dread and fear often imagining what it must be like to be surrounded by death. However, when you meet our colleagues who work in the mortuary at City and Sandwell it is somewhat reassuring to see that the mortuary is a calm, even homely looking place aimed at making loved ones feel at ease during the most difficult time of their lives.

Heartbeat caught up with our Mortuary Service Manager, Jessica Arnold who told us more. “People often have misconceptions about the mortuary and what we do – our aim is simple – patient care. We look after patients who have passed away and ensure they are taken care of until they leave for a burial or cremation.

We can deal with very emotive cases but the team are here because they are compassionate and caring.”

We asked Jessica to explain the flow of a patient leaving the ward and going into the care of the mortuary.

She said: “When our patients are brought down by portering colleagues, part of our role is to check their paperwork is in order. We check that the patient has the correct ID and that all their personal belongings are accounted for. Patients are also measured as part of the requirement for the undertakers who require the measurements in order to prepare the coffins. There is a beautiful handwritten register where we write the patient’s name, date of death and the name of the undertaker. The information is also recorded electronically.”

Five technicians make up the team in the mortuary who all take part in undertaking post mortems. Jessica explained that not all patients have a post mortem and it depends on whether the cause of death is known.

“Post mortems are usually carried out if a patient dies unexpectedly,” said Jessica. “The process is meant to piece the puzzle of how someone died. Our coroner’s jurisdiction has access to a digital autopsy which is situated at Sandwell crematorium; it is a scanner that helps to ascertain the cause of death limiting the need for invasive procedures. In some cases the scan can be inconclusive so we have to carry out a full invasive post mortem.

“As technicians we remove all the organs in preparation of dissection and examination by the pathologist. This can sometimes result in further examination where blood and urine is collected for further testing in the lab. Once it is clear how a patient has died, the coroner can issue the necessary paperwork for a funeral to take place.”

It’s hard to imagine what it must be like having to deal with patients who have lost their lives and their families.

Kulwinder Johal, Clinical Directorate Lead has recently taken on the overall management of the mortuary. She said: “Dealing with people in a bereaved status is very challenging. I am in awe of how the team take care of our patients as well as manage the expectations of loved ones.

“They often have to have sensitive conversations with families to prepare them about what to expect when they see their loved one.”

Jessica added: “We are not a funeral home so we are limited as to what we can do to prepare patients for viewing.

But we do ensure that hair is brushed or combed and that the eyes and mouth are shut. The aim is to give the impression that the patient is sleeping so we lay them on a viewing trolley that looks like a bed.”

Kulwinder aims to raise awareness of the mortuary service and the amazing work they do. “I don’t think colleagues around the organisation fully understand the work and skill that goes into caring for deceased patients,” she said. “We have just gone through a Human Tissues Authority (HTA) inspection and there is a lot of structure and accountability required to run a mortuary service.

“We have worked together with our colleagues including clinical nurse practitioners, bereavement support midwives and ward managers as part of a stakeholder group involved with the deceased to achieve the standards of the HTA and deliver a coordinated approach to the way we care for deceased patients.

“Together we work to ensure patients are laid to rest quicker and we also provide training particularly for the rapid release process. The rapid release process ensures that a death certificate is signed on the ward at the time of death (if cause is known). A signed form is issued to the family who will give authority for the body to be released. The patient is then escorted to the mortuary by a ward colleague and handed over straight to the undertaker. When done right, rapid release can take up to four hours and is a great comfort for families as they can lay their loved ones to rest.”

Jessica commented: “Part of the work of the stakeholder group is also to ensure families are supported throughout the process and where necessary direct them to services that provide financial support.”