Why can only doctors confirm deaths?

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Anonymous #1
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A nurse can surely confirm a patient is dead after 3 years of training. They can do all the checks a doctor does. It doesn't make any sense how a junior doctor can sign off a death certificate but a nurse can't?
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username4222532
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A nurse cant right out a perscription
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ecolier
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(Original post by Anonymous)
A nurse can surely confirm a patient is dead after 3 years of training. They can do all the checks a doctor does. It doesn't make any sense how a junior doctor can sign off a death certificate but a nurse can't?
Most of the time, practically the nurses know if a patient is dead or about to die.

However there are cases that patients seemed "dead" but actually had reversible, treatable causes of pathology (e.g. hypothermia being a prime example) and they "came back to life" after treatment. The nurses wouldn't have had training in diagnosing that.

Plus, patients on ITU are often in deep coma and the line between that and brain death can be blurry.
Last edited by ecolier; 1 month ago
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Anonymous #1
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(Original post by laughinglad999)
A nurse cant right out a perscription
They can take prescribing courses i think.

(Original post by ecolier)
Most of the time, practically the nurses know if a patient is dead or about to die.

However there are cases that patients seemed "dead" but actually had reversible, treatable causes of pathology (e.g. hypothermia being a prime example) and they "came back to life" after treatment. The nurses wouldn't have had training in diagnosing that.

Plus, patients on ITU are often in deep coma and the line between that and brain death can be blurry.
They should receive training in it. It would save a lot of time and doctors and save unnecessary time waiting for doctors. Can't an ECG and a torch in the eye show if a patient is dead or alive. Oh yeah I understand if a patient is in a coma.
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ecolier
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(Original post by Anonymous)
...Can't an ECG and a torch in the eye show if a patient is dead or alive...
It is more complicated than that...

For a start not everyone in asystole is brain dead. and not everyone with no pupillary reflexes is dead either.

Plus. confirming death in most cases is done by junior doctors anyway - it is just part of our work. And it doesn't take that long.

Taking blood, on the other hand, really should be done by nurses but are not (in the UK anyway). This seemingly mundane task takes away hundreds of thousands of hours of junior doctor time.
Last edited by ecolier; 1 month ago
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Bexjw
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(Original post by Anonymous)
They should receive training in it. It would save a lot of time and doctors and save unnecessary time waiting for doctors. Can't an ECG and a torch in the eye show if a patient is dead or alive. Oh yeah I understand if a patient is in a coma.
Oh my days. 😳
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Anonymous #1
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(Original post by Bexjw)
Oh my days. 😳
That's normally a few of the tests done. By no means the only thing used to identify someone as dead.
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Anonymous #1
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(Original post by Bexjw)
Oh my days. 😳
No need to be rude either. I'm talking from personal experience where I saw doctors do an ecg number of different tests that a nurse could do and then confirmed death. This would be different to patients who were in a coma etc.
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Anonymous #1
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(Original post by ecolier)
It is more complicated than that...

For a start not everyone in asystole is brain dead. and not everyone with no pupillary reflexes is dead either.

Plus. confirming death in most cases is done by junior doctors anyway - it is just part of our work. And it doesn't take that long.

Taking blood, on the other hand, really should be done by nurses but are not (in the UK anyway). This seemingly mundane task takes away hundreds of thousands of hours of junior doctor time.
I wasn't talking about confirming the death takes long. I meant waiting for the doctor to come and confirm the death takes long as they have a lot of other jobs to do. I agree they should be able to take bloods as well.

What proportion of the medical degree is diagnosing death I would think a small part or is it more part of holistic care.

I'm sorry if I sound naive :-(
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ecolier
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(Original post by Anonymous)
...I'm sorry if I sound naive :-(
No, don't be. It's good that you're interested in niche topics like this.

(Original post by Anonymous)
...What proportion of the medical degree is diagnosing death I would think a small part or is it more part of holistic care...
It depends on the medical school. I personally learnt it as part of the anaesthetics block (since the ITU is staffed by anaesthetic doctors, and they are really most qualified at this).


(Original post by Anonymous)
I wasn't talking about confirming the death takes long. I meant waiting for the doctor to come and confirm the death takes long as they have a lot of other jobs to do...
The thing is, this doesn't happen very often. Thankfully not a lot of patients die in hospitals routinely - with better palliative care it is planned when and where someone is likely to pass away.

In fact this is one of the few jobs that doctors really wouldn't mind doing, since it doesn't take a lot of time and is fairly straightforward. It's completing the death certificate afterwards and writing up the crem form that takes longer (but then you get paid for writing the crem form... at least for the next few months!).

Taking bloods, on the other hand, while it doesn't take long there are soooo much of it that cumulatively it takes way more time. Plus virtually all European nurses, and all US nurses (as far as I know) have to know how to take blood.
Last edited by ecolier; 1 month ago
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TheMandalorian
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(Original post by ecolier)
No, don't be. It's good that you're interested in niche topics like this.



It depends on the medical school. I personally learnt it as part of the anaesthetics block (since the ITU is staffed by anaesthetic doctors, and they are really most qualified at this).
Is it possible for people to come back to life when in a morgue?
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ecolier
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(Original post by BuckHowls)
Is it possible for people to come back to life when in a morgue?
It's not unheard of, some people are even found to be alive at funerals.

The thing is, there are a few medical conditions (including drug induced) that can really accurately mimic death. Hypothermia is a prime example and some people make a good recovery from "being dead" with no pulse, no breathing, fixed pupils etc.
Last edited by ecolier; 1 month ago
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Anonymous #1
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(Original post by ecolier)
No, don't be. It's good that you're interested in niche topics like this.



It depends on the medical school. I personally learnt it as part of the anaesthetics block (since the ITU is staffed by anaesthetic doctors, and they are really most qualified at this).




The thing is, this doesn't happen very often. Thankfully not a lot of patients die in hospitals routinely - with better palliative care it is planned when and where someone is likely to pass away.

In fact this is one of the few jobs that doctors really wouldn't mind doing, since it doesn't take a lot of time and is fairly straightforward. It's completing the death certificate afterwards and writing up the crem form that takes longer (but then you get paid for writing the crem form... at least for the next few months!).

Taking bloods, on the other hand, while it doesn't take long there are soooo much of it that cumulatively it takes way more time. Plus virtually all European nurses, and all US nurses (as far as I know) have to know how to take blood.
Thank you so so much. I understand it a lot more now. Yeah nurses should be taught how to take blood, it would free up a lot more of the doctors time.I appreciate you taking the time out to inform me and I wish you well ❤️
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ecolier
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(Original post by Anonymous)
Thank you so so much. I understand it a lot more now. Yeah nurses should be taught how to take blood, it would free up a lot more of the doctors time.I appreciate you taking the time out to inform me and I wish you well ❤️
No problem. Feel free to ask more medical Qs here (but we can't diagnose, that's all)
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FRS500
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(Original post by laughinglad999)
A nurse cant right out a perscription
Now they can! Nurse Prescribers are a thing now.

They have their own BNF. Helpfully called the NPF now!
(Original post by Bexjw)
Oh my days. 😳
hahahahahahahaha
(Original post by Anonymous)
Can't an ECG and a torch in the eye show if a patient is dead or alive.
Mate... this is a hospital, not Kwik Fit.

Shine a torch and hook up to a machine. Yikes
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Bexjw
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(Original post by FRS500)
Mate... this is a hospital, not Kwik Fit.

Shine a torch and hook up to a machine. Yikes
Not gonna’ lie, that proper cracked me up! 😂
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Anonymous #1
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(Original post by FRS500)
Now they can! Nurse Prescribers are a thing now.

They have their own BNF. Helpfully called the NPF now!

hahahahahahahaha


Mate... this is a hospital, not Kwik Fit.

Shine a torch and hook up to a machine. Yikes
That's two of the many tests doctors do when confirming the death of a patient. Instead of sniggering you can provide some useful input or go.

(Original post by Bexjw)
Not gonna’ lie, that proper cracked me up! 😂
But couldn't reply to my comment above. Nice to know.
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Bexjw
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(Original post by Anonymous)
But couldn't reply to my comment above. Nice to know.
You quoted me twice looking for an argument and saying I was rude, so forgive me for not wanting to engage further.
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Anonymous #1
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(Original post by Bexjw)
You quoted me twice looking for an argument and saying I was rude, so forgive me for not wanting to engage further.
Because you were rude. I'm a student looking for advice and instead of giving it you laugh and then communicate with other users on this site to further mock me. If I'm not mistake that's not constructive.
Shows ecolier is a medical doctor who actually wants to help people on this site compared to you.
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Sabertooth
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(Original post by ecolier)
Taking bloods, on the other hand, while it doesn't take long there are soooo much of it that cumulatively it takes way more time. Plus virtually all European nurses, and all US nurses (as far as I know) have to know how to take blood.
Really? Only doctors take blood in the UK?? That's crazy.
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