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just receiving that card in here, Okay? Yeah. So Yeah. Okay, that's what that's gone on. And so this is why we're doing this session today. So you hopefully you'll be able t b. Yeah. Should know exactly where to start and feel more confident about doing it. Um, so that's perfect. So you don't call your own a night shift on? Do have been blinked by one of the senior nurse is on the ward just informing year that patient has just passed away. So who are you speaking on the phone to seal off the gap leak. But they won't say Here it is. So it's really important. Just big sex. So in the exactly here speaking, who's Who's the patient concerns? Are you aware of their history and what's their backgrounds? Do you need to get there right away? How How long was it being since they've passed and it's the family there. These are all things that you kind of initial thinking. So was it unexpected, unexpected death that they have a D, any arts that too, has the family been informed and has are they in the room present? Have the hot and he's also very commission or burn. Yeah, so what? You should be a prior to verify and the death. So all importantly, you should always check to see if they've hardened E N e r. And said checks. And so usually it's kept in the front of the notes always, and it's a really obvious red form. And usually after a part of patient or isn't a spirited, then they usually will have. These done and be should have them done, especially whenever they're Clark done. But sometimes it doesn't, um, you need to be aware to check for that and suggestion of you. Their notes gain further details about their background. If you don't know the patient on, then if there is an uncertainty to what the resuscitation status says that CPR should have started, there's any types that they have just suddenly lost, conscious and need resuscitated. But often the case is is expected, and it's just about you compartment and verifying the death and then discussing with the family members after and documented yeah, so are there any family members present in the room with patients? So often? Whenever I was a male stir fry on the result and most of the times the family were in the room present with the patient. So whenever you had went and just go and explain the need, t confirm the death and you need to verify it and offer you consult dances and say that it could be present in the room if they wish it's up to themselves. But just using that on board communication skills and and because they just lost their local on check is they have any questions or concerns and just kind of calm and sent stuff, really. But to just be aware that they can be in the room whenever you're going to verify the deaths if you're walking in. But just expect TOB having that conversations because there's nothing worse than no new in the background dissipation and walking in to go and verify it. Uh, the death and they're nowhere. So here's a step by step guy. You don't hi to exactly verify death. And so even if you're not sure at the time, whenever you're on shift like there's always Social is available town. So even if you, uh, sometimes whenever I was that started, I I and I always just brought the the geeky Maddix and site on. But let's really looked at the step by step process and her two documented and things, and that will definitely give you a good guideline. And but yet, essentially, just make sure you wash your hands on gloves and then confirmed their identity so really, really important. So compartment with the respond, Um, making sure is the right patient and inspection. So any obvious signs of life. So any sense of movement, any science of the chest and respiratory effort we made, I'm specifics. The response. Teo. Any verbal stimuli, eyes or even if you're just a Hello, Can you hear me like that? I know it sounds stupid time, but you need to be confirming. Is there any verbal response is they're anti responsible? Assess the patient's response to pain. So there's a variety semesters that you can use for that. So one of thumb is printing the pen pressure to the patient's fingernail and hold it. There is usually really uncomfortable, often patients. It's the the lark. They will want you to get off because it's really painful and even the same as the trapezius squeeze. So just pension in between and the craziest and muscles and then applying even super orbital pressure suggest, and above for just where the library is and there's the to you and super orbital notches. So if you press on that and often that alert and stimulate up in response and and then assess the really reflexes so you need to have a pant or church, even just the flashlight on your phone and soft and when patients have passed away and the pupil peoples will become fixed on dilated, so there will be no response to this, and pillory light reflex on day will be flexed. And it will become very obvious that has any of you seen any patients that has has passed away at all in the hospital? Because I have not until my ass ear or that I've seen I don't listen. 11 or two a day and at zero. And then we were pit right end Teo to do in and sort of nuts whenever we're in F one. So I'm Yeah, it's just it. You take some time getting you still even, um, What's someone? Just one? Yeah. Yeah, I like. I'd literally just seeing the one and it does does take you back about whenever you actually seeing someone because you're so used to seeing people in the hospital that are coming in and they're interacting with you. And whenever you see someone, that is to say, stuck it. That those kind of factor, Um, but yet so assassin people, every reflexes, silence and did a system I coach so work Marie Road. So I would assess the people area faxes. And then what are we going to do the and pop it for the carotid artery and which will be absent on then so, usually in theories and according to the guidelines. But usually it's up to you, so you need to have a least listened to the heart and respect to science for a least five minutes. That's last week, 2 to 3 minutes for both. Usually, I just document that I've listened to them for 30 minutes, and that is what I do just to 10. Sure that it's definitely confirmed. It's been over five minutes that you haven't heard any heart or respiratory sense and then wash your hands, Spoons of PP, and then, all importantly, just document. Ever since, and especially the time of death that's really important. And your name on your GMC number, because if there's an Athlon that's coming on after your chef, if you've been on eight shift and you have just and verified the death. But they're the ones that need to fill out the documentation afterwards, so they need to have your name on your GMC number two. Put on this form so it could be quite operative is pearly documented, and it just makes the person who's coming after your life a lot easier. It's and if you've documented accurately so yet documentation. So here's just a Nexium sample. So put your name on. I normally put my gyn C number at the end, and but even just put your bleeding number as well is also useful and just a brief description initially. So always put the date and time that you're writing the documentation you can then pin about background about homes. So you were informed by nurses south at this time that this patient assuring all signs of life I am just a background. Is there a politician, but with someone with and if it was expected unexpected on. But he was there in the room the time and worthy in the room while you're verifying the death with the relief and verification. So just document everything that you've done usually get manic still skips a good I've line as well and just documenting said, no response to painful stimuli Newhart Science or Risperdal Science for the five minutes North Central Part pulse on. But peoples are both fixed and dilated on Do Another important thing. So if a patient is, if the family has decided that they know that they want them to go for cremation and two important things that you need to check our happy, hard, any hip replacements. And so if they've got any gamma meals and that's significant and then not do they have any pacemakers? Because these things are really they need to be removed. This actually before they're committed. Otherwise it's come, I'm exploding. Think so? Yeah, no, they need to be aware. And if they've got pacemakers or if the goal added previous have placement. So even just looking back through previous chest actuaries as well that you also just reconfirm. And if they've had, like a chest X ray in the day prior or something like that to condemn me. Just confirm that there's no pacemakers, presence of something else, that you could just be remind and date and time of death. So it's the time of death is when you complete verification. So just that time is no. That's the time of death so that sometimes you don't come out, and that's the time that goes on. The and I see are so now that you verified life instant. So what did you after that? So it's all this documentation and handed over. So if you were the one that was just finishing nights, then and sometimes you might be hounded over two members coming in and for the day team just to sort of the medical search of chips and of death. So the N. C. C. D is essentially what is called so through the electronic healthcare records. See, there's tops of the tall I'm. Usually you just click on the rule in a pathway. I'm so it's pathways. It comes up but the hall, but one of the tops. And then there's an option of beside so morbidity and mortality a pathway, and you collect and rule in the pathway and then it says, really want you. You do get a few times. It is stuff explant trade. But you're basically looking for the past week and then roll on or tile team or ability passed away and then just filling out all the details on completing it through that. So it should what you've done, that this creates a form that should essentially be emailed to the MG are open damage and site. And two, usually you, the name and the contact, the ills details for the next 10 and the email. And it's just and important to give that information to obtain and the information prior to register the death. And so once you've done that, it's just important to bear mind that you need to email it then to this and this email address afterwards going from there. So sometimes, depending on the circumstances of the death, you might need to have a discussion and report it to the corner for further investigation. So that means whenever you're filling out the pathway, um, you're going through the pathways you're going through the morbidity and mortality and rolling and a pathway, and it gives you comes up with options on the actual peach off. And if you have discussed it with the corner used to be a number that they give you. So you got to whenever your contact in the corner and I had a few cases like this and you're on my iPhone wherever I was and especially on the weekends, always happened to me. And I was that person that always got on the weekend. And but, yeah, you have to actually go through such word and contact the corner service on. They'll put you three to a number, which then they ask for a while the details. So it's just the same exactly as you would fill in a normal and and CCD and form just going through. So I should fill out this, that around us to either possible just all the details leading up to this and to the death. So then you have to discuss this with their someone that takes and records all of these details, and then they submit it, and then the corner reviews dependent, and then they get back to us actually us to take a number from you, and then they get back to you. If they want further investigate further investigation. So further corners and best earth. If not, then if they're aware of it and then they give you a number to put on the form. So it's quite daunting whenever your first not situation, so that because all of this and all of these forms are legal documents and that needs to be filled out properly and whenever you're on A, we can't just unders a million other things to be doing, and it can be quite stressful whenever you're trying to get. I gave his strain Blackground documented and, well, spin bleeped, called still eight the same time. So it is quite stressful but just is important and it needs. Don't go just whenever you're doing that. Just bear in mind that these air this sorrows essentially where you would be considering, reported it to the corner. So if there's any cause of death that was unexplained or any circumstances that maybe require further investigation needs reported to them, and if you haven't actually seen or treated the person that from which they died within the 28 days prior, that similar indication for Dan it on. But I want my first never want I ha the next one, and they had exposure to this past. Also, I'm you had Teo. Just make sure you go through all of their past medical history because it wasn't calm and they're Clarkin or anything, but it was on the CR, so just be vigilant. Was the prostatic a history and and just careful documentation? And then you'll design. That's your if you need to fill in the corner. It's straightforward enough, you know, it's quick, don't and when you initially did it. But and if you just go through such words or press here on the phone literally asked me, Put through to the coroner service. There's often people and not it's and department that are really helpful. And we'll advise you. Thanks. And if there's any questions or Anderson, you can always give the service suffer with this. Well, okay, any questions about that? No. So by allergic remission. So there's a few times that whenever I was working and then sexy and the Ulster that was the there's a lot of pollen of patients, essentially, and it was the hematology on it and gastro ward. But there was a lot of pollen is, and patients that the family's had already computer conclusion and decided that they want to talk a nation. And so in that circumstance, there is a separate form that you have to stay light on. Be all stir. It was usually cat on, but there was like a separate books that was in one of the covers. And if you just asked one of the senior nurses, they know exactly where the farms there kept on. But usually it's the acid bit. More details about saying so whenever you're going through the forms, if you're not sure, just ask someone. I'm senior, but it's is straightforward enough once you go through it. But it's just a lot more Indian depths detail of exactly what time When did you last see patient on Were you directly involved in their care, like just certain questions like that? And then it requires that you actually go down and confirm so often if you haven't had if you have a chance of you there if you are the one that verified the death, but you're filling the cremation form afterwards when you're filling out the and CCD, so you you know it can be not scenario where someone does just came off of nights. They have verified the death. But you're responsible for doing the form on the electronic care healthcare record, the MCC day, and then you're responsible for doing the cremation form after that. So you might not have actually seen the patient on day when they were being verified. So you need Toso actually go down and see them for yourself and make sure that they don't have a pacemaker and confirm that they don't have any previous head and Gamini replacement surrounds and like that so often. In that scenario, you will be going down to, um, wherever in the hospital, the and the where they keep thumb and the just prior to be in and taken away on. But usually and they'll start was. Besides, it was just passed the day, so it was passed radiology, and then you went to the right when I went into the the more So yeah, this It can be quite an experience if you've never seen it before, so it's just to kind of period for that. I'm you dio the more you see them or you do get used to it, but and it can be quite Don't initially, whenever you start and they're in them, the information forms are totally separate. So you you do all the MCC day, and then the cremation forms or separate. And usually it's a good practice to be the person to adults. Information form is the one that has don't land CCD. Okay, um, any questions? That's just some of the useful ops that would recommend. So induction the one of the bottom right is. And I useful up just for Gandel the numbers that you need to and and it could be tailored to the trust on day foundation. Hot, big doctor. That's really good for an emergency situations given you exactly what to do. And certain ones. I think you got to pay for that one. And pocket doctor is another good one. MicroBite be an ass and the color and for your well, scoring on things like that, I'm Yeah, if you use could feel like it and something bucks, that would be a five. But certainly any questions at all? Um, these what? These sessions or four. If you solve any questions or if you're not sure, do you feel more constant was being able to do it. I and yet three for our love books. And we got any nose spray and that. And if we hadn't felt like there like that, and she's a CT sample thing that we could geez, like this session if the way to, like, get it signed off. All right, here, I'll just write. I'm I'm actually, um oh, my no, on my laptop here. But I'm just trying to Okay, yeah, if you type that story, but let it It's just I'm no, my lap talk, guys, if you any questions, it's old. Just I'm You can always email one of us, Um, or even just asking the metal site. And if any of used don't have access to it, we can also send out, but it's just it's literally comes up the, uh, PSA's and f Y zero teaching and folder. And then it should have all these sessions on that. So that so the sex one that have done now. So the next session will be doctor, my patient has and posture and all day, um, let me see here. So you got email to see if you have complete it. Oh, that this session would print for that. Yeah, I'm I'm not too sure. I could certainly ask. And but it covers all the rounds and information that you need to know, so I don't see why not. Um, I can certainly check for you. No worries. Um, but yeah, it's ah, we're trying to recommend just to just try and get involved in try and confirm or verify one. Well, sure. And Axiron because then you'll you'll definitely feel more constant was doing it whenever you're right there on your old, um and certainly just don't be afraid to get. And just look at the APs and guidelines and things before going and and just being constant whenever you're going. And if there is a family member there, just be sensitive to that on, especially on a bill. Appreciate it up. I think that says and like, you school and get some lunch. Any questions at all? Just last. Know Nori's right. See you later.