I work in a Mortuary - AMA

[MortuaryAMA]

I know this is a sensitive topic, but in day to day life I get so many questions surrounding what it is like and how I deal with certain situations.

I will answer as honestly, tactfully and sensitively as i can.

I always use their name, apologise to them, tell them what I am about to do, as I would a live patient.

This is beautiful. What a wonderful person you are. My dgf passed away last year and it means so much to know that the people looked after him after he passed away might have done this too. I hope they did.

MortuaryAMA , thanks for answering about the body donation , I will look into it more closely. Probably have to go on a diet before they accept me

This is very interesting but quite scary too. i had no idea organs were removed and weighed. I am horrified by this. What is the reason for it please ? I would not like this if I died, and the thought of a PM is horrible. Is there any way you can ask for this not to be done?

What is the most interesting case/post mortem you've worked on - if that's an ok thing to answer. Please ignore if not!

It's fine, I can share with you. The ones I find the most interesting usually yield an unexpected element. I have worked on people who have supernumerary organs (such as a biconcave womb and once an extra spleen!).

So with that in mind, the case I found the most interesting was a lady who had apparently had a heart attack while in hospital for treatment for a broken femur.

When we examined her we found that she had indeed suffered a hear attack. However, upon examining her brain we found a large tumour. She had no history of symptoms usually related to brain disorders in her notes and herself and the family had no idea. Completely unrelated t her heart attack, too.

OrchidFancy

With everything we do in the mortuary we try our hardest to make is as pleasant as we can possibly strive to for the family. I hope you can rest assured that your dad and all the other patients are dealt with respectfully and, even when we have to do a post mortem, we are careful and will only ever do what is necessary.

You are welcome, and I am sorry your family and yourself had to go through it all.

MaitlandGirl

Thank you. I believe it is so important to recognise them as a human being. I don't ever want to lose that and I will always respectfully call my patients, my patients.

I don't work at the Royal Berkshire, and 1999 is a bit before my time, however I am pleased to hear your experience was as positive as it could be in these circumstances.

Arkengarthdale

Thank you. It's so nice to hear that. I was a bit worried about starting this thread, but knowing it is appreciated has reassured me [smile

Where do the babies go? Is there a special room for them?

There is a special room for our babies, yes. We have baskets, blankets and little outfits we put them in, and teddies we have for them too, all kept neatly. We also have the hand and foot printing memorials taken there. Our room is yellow and has a lovely picture of elephants on the wall.

That feeling of them being alone isn't pleasant at all. There is always someone around for them though, and for the families, whether it be us, the midwives, our amazing chaplains and ourselves.

Do you mean there are 4 staff, each working on one patient at the same time, or does one member of staff go from patient to patient, carrying out one type of procedure on each and then moving on to the next sort of procedure on each, if you see what I mean?

I think I understand. Yes, of a morning we will have 4 patients (we have 4 tables in our suite). Each PM is done by one person, and completed in one go before moving on to the next patient. So we will have, for example, two staff to two patients. We both complete one each at the same time as each other and then move onto the next, so we both do two PMs. I hope my reply now makes sense

TheGoldenWolfFleece

I am sure they would have. Of the trusts i've worked in and people I have met in the profession, they have all been kind and respectful to their patients.

ggirl

No problem! I am insure about upward weight criteria, but I know that they generally don't accept very underweight patients.

lightonthewater

I am sorry about the feelings this thought has left you with. Everything we do has reason behind it and we never go further than is absolutely necessary.

We weigh the organs because they can give us a clue, if it isn't obvious, as to any underlying conditions which may have been a factor in a patients death. For example is a patients lungs or lungs are heavier than expected it could indicate there is fluid in them, or a light brain may indicate a neurological disorder.

Unfortunately you or yourself cannot decline a PM if one is necessary. However, you can rest assured that we would only, ever do one if it really, truly is necessary.

Not really got any questions as I have been and watched PMs taking place myself - worked in surgical/emergency field for the past 12 years. It was so fascinating!

How do you deal with the smell though? I couldn't wait to get out and shower

Thank you for replying. That's a comfort to know.

Thank you so much for answering, OP - this is such a valuable thread

On the subject of PMs, I realise you only do what's necessary but can I ask what happens when the patient is from a culture where these are unwelcome? Would the procedure have to go ahead all the same, or would it be waived?

Thank you for answering my question

Fascinating. No questions, but I've learned a lot from this.
It sounds as though you carry out your work with great sensitivity and compassion

Are babies placed with an adult corpse still? They used to be when I worked on the wards so they weren't alone.

Fascinating thread OP.

Have you dealt with many murder victims?

Do you deal with many that have in a bad condition, like from a car crash for example, and does that make is harder for you?

How do you deal with the smell though? I couldn't wait to get out and shower

From the other way round, I've observed surgeries, which i find equally fascinating. The sheer precision needed compared to us is astounding. We recently had junior docs in to practice laparoscopic surgery on donated patients, which was a nice meeting of both worlds.

As for the smell, It becomes bearable after a while, although every once in a while it will catch me unawares. It does cling to you though, it gets into your senses and I can smell it in my hair after work sometimes (although others don't appear to notice). We have the added bonus of showers at work, so once the PM's are done - if they were particularly smelly - I will grab a shower afterwards.

can I ask what happens when the patient is from a culture where these are unwelcome? Would the procedure have to go ahead all the same, or would it be waived?

At present they are unable to prevent a PM happening if it has been ordered. The decision can be appealed but it's very rare that the appeal comes through in their favour.

However, we are currently trailing the use of CT scanning to determine the cause of death, and we have representatives from religious communities who we can work with to facilitate this. Unfortunately it can't always detect a cause of death, so in these circumstances a full PM will then be required. We will always try and do this as soon as possible if needed, and can even request a male or female pathologist if this is required (although this cannot be guaranteed).

Overall we try out best to respect the spiritual wishes of the family and will do what we can to assist them in that.

Are babies placed with an adult corpse still?

No, they are kept in an area especially for them. It wouldn't be seen as appropriate, unless the baby was with it's mother, to keep an adult and baby together.

Have you dealt with many murder victims? Do you deal with many that have in a bad condition, like from a car crash for example, and does that make is harder for you?

I'm afraid so, on both counts. We recently had a very harrowing murder case a year or so ago that hit all of us incredibly hard, because of the age and circumstances in which the person had died. I had to take a couple of days off after that one actually.

Violent deaths which aren't murder can be equally horrific (crashes, falls from height etc). I am going to spare the details but some of the states people come in to us are unimaginable, but we do everything we can to put someone back together and make them look like they did in life. Reconstruction is something I am learning from my manager at the moment, and you wouldn't believe some of the people they(manager) had worked on had ever been in an accident.

As a completely unrelated aside, if you (or your family) are a motorcyclist, regardless of how unbearably hot it can be, wear your leathers (or make your loved ones wear them)!!!! A bit of sweat is nothing compared to losing your life. Same goes with seat belts.

Thank you.

I hate motorbikes. I have a family member who is a biker and it scares the hell out of me. There have been some really bad accidents near me, including a horrific one where the injury was just terrible.

I also had a friend who would never wear a seatbelt in the back. Another friend refused to drive off until she had done it up as she had lost a close friend in a car crash when she was younger. Just not worth it.

Regarding transporting bodies to the morgue in hospitals I used to think that it was done in “disguised” trollers until my experience in one perticular hospital. My mum used to work in the hospital and my Dad had a major op in the same hospital. He was in theatre 9 hours so we did a lot of hanging around. Whilst we was there there was a major crash on a local road killing a family of 4. I can only assume 3 of the family passed away on the way to the hospital as I saw 3 cofffins being wheeled through the corridors. I asked my mum at the time and she confirmed that they were coffins. I can only discribe them as wooden coffins on top of a metal trolly. About a week later I actually saw one parked up in the entrance to my dads ward. I can only assume it was empty and waiting to transport some one who has just passed away. It had always played on my mind. Fast forward 2 years and both my mum and dad died in the same hospital 6 months apart and the same coffins where used. I actually commented on them to the nurses and they told me it was a practice that they have disagreed with for some time. The worse thing was my mum and dad where wheeled in the coffins from the cancer ward and straight passed the people waiting to see there oncologists. I can only imagine the feelings of some one waiting to see the oncologist at the beginning of a cancer diagnoses watching a coffin coming past. The nurses did close all the doors on the ward but that was all. Is this anything you have heard of before. I did contact pals and got an email telling me this is just standard practice. I have spent a lot of time in other hospitals due to MIL having a perforated bowel and heart surgery but have never seen it there.

That's awful pud1

It definitely isn't what I've seen in the hospital where DF was. The deceased patients were transported in body bags on a standard trolley but had a white sheet draped over them. If you didn't look properly or weren't aware if what it was, you wouldn't think it was any different to a standard patient being wheeled from ward to ward.

pud1 That's so awful. Especially for people receiving treatment, as you say, but for everyone really. I assume you're in the UK? That's not something I've ever seen in a British hospital either when visiting or as a patient.

Where I worked before (NHS) Hospital they had a trolley that was quite large and a big box type with a canvas that pulled down over it. You wouldn’t really know to be honest!

Does your hospital have separate mortuaries for adults and children?
Is it common for them to be separate?
I applied for a job a while ago as a trainee pathology tech - job description was pretty much what you’ve outlined your job to be. I’ve always been interested in the field, but then just before interview stage, it was revealed that the position was solely in the paediatric mortuary Unfortunately I lost my nerve and decided to give it a miss. If it was just adults I’d probably be ok, but as the mother of 2 very young dc’s, the thought of a paediatric mortuary really shook me

This is so interesting OP, thank you.

You said earlier that one of your roles is to remove and weigh the organs. Do you do all of that, including making the incision etc yourself? Or does a Dr do the actual cutting and removing and you do the next bit?

Yes it is a uk hospital. It is in Lincolnshire. It’s funny really as my dads passing was awful with lots of pain and went on for 10 days but it’s the coffins that have stayed with me. On the other hand I know that it had no bearing on the care they received in the mortuary as most of the technicians knew both my mum and dad.

This is really interesting, thank you OP.

It's a career path that I have always been interested in, but not sure I could cope.

Do you find it hard to 'switch off' from distressing things at work?

Anonnymouse54321

Ironically, I am a biker myself. There is something about this job that can make you incredibly reckless, and I guess having the bike is my one, big, reckless pleasure, although I am reckless in other ways, too.

pud1

That practice sounds incredibly disrespectful to all involved and I apologise for your experience. As far as I know, most PALS complaints will be forwarded straight to the management of the department involved unless the incident is serious and involves them directly. I have never seen this practice anywhere myself and any coffins I see are brought via the back door by funeral directors!

If you walked past a deceased patient in our trust you wouldn't even know it. We are very, very discreet and you would have to know what our trolley looks like to recognise it.

Does your hospital have separate mortuaries for adults and children? Is it common for them to be separate?

Ours doesn't but I know of hospitals that do, and of course GOSH and other childrens hospitals will be solely children.

Id say we are lucky in that we don't see many children come through our doors. Unfortunately when they do though, it is forensic or coroners cases. Kids are hard enough but it's especially heartbreaking and makes it incredibly difficult. As a mother I have to remember that it's not my grief though, and make sure I occupy my mind in my downtime.

You said earlier that one of your roles is to remove and weigh the organs. Do you do all of that, including making the incision etc yourself? Or does a Dr do the actual cutting and removing and you do the next bit?

Yes, we make all the incisions, remove all the organs and put the patient back together afterwards. The pathologist takes the organs to a separate table and inspects them.

covetingthepreciousthings

IT can be difficult to switch off at times. That is why having a supportive team, a loving husband and family and a good friendship group is important.

Some people, like me, are surprised by how well they cope. Others realise it's not for them at all, but you will never know until you see it if you know what I mean. We have had interviewees, trainee police officers etc faint on us, and that's just in the viewing gallery!

That’s so interesting. There must be quite a lot of training for the removal of the organs, eg knowing where to make the incision. Or is one incision made and all the organs removed from one large incision?

A really interesting thread OP.

My question is, my Dad is adamant that he doesn't want a funeral and says that its possible for a family member (or anyone else who has a copy of a death certificate) to collect a body from the mortuary and transport it to a Crematorium themselves.

In short, he wants us to collect him (if we are ok about this, which I am) and have no involvement from any Funeral Directors.
OP, do you know if what my Dad says is indeed possible?
And if so, have you ever released a patient's body to be collected by their own family or friends?

Can you tell me why you remove the organs? What is the reason? What if the person specifically didn't want this to happen? Would it be respected?