Mr. Smith was dead when I arrived at my shift. Apparently he had died a few minutes before I arrived.
I walked into the room and noticed his seriously yellowed-complexion. Hello jaundice. I was told that his cause of death was liver failure, but other than that, I really knew nothing about him.
"Have you done post-mortem care yet?" Kate asked me.
"Well, since he's not having an autopsy, we'll take out all the IVs, his ET tube, his central line, his Foley, all that stuff. Then we'll clean him up and then we'll bag him and tag him. We'll put one tag on his toe, one tag on the bag, and one tag on his belongings." She explained nonchalantly.
The monitors had been turned off and the room was quiet, but Mr. Smith's body was still warm. I donned a pair of gloves and gingerly began to peel the tape and the tegaderm off of his arm, preparing to remove his IV. I had never taken out an IV, a foley, or any kind of line before, so in some ways it was nice to learn on a dead person. After all, I knew I couldn't hurt him. I pulled out the IV and blood started to drip down the side of his arm.
"Can you hand me a four by four?" I asked Kate. By this time the blood was pooling on his pillowcase. I had no idea this would be so messy. I held pressure for a minute, peeked under the folded four by four, but he was still really bleeding. I continued to hold pressure while I removed the dressings around his arterial line.
"The A-lines can really bleed a lot, so be careful." Kate said.
Prepared with another four by four, I pulled out his A-line.
Meanwhile, Kate was removing the dressing and sutures for the central line. Mr. Smith had finally stopped bleeding, and I attached an empty syringe to the port on his Foley and drew out the saline. Armed with another four by four, I slowly pulled out the catheter. Kate deflated the balloon on the endotracheal tube and carefully removed it.
Prepared with a basin of soapy water, Kate washed his face and I cleaned up smears of blood. Together, we turned him onto his side. Upon death, Mr. Smith's sphincter must have relaxed and released a huge puddle of liquid stool. As we shifted him, what seemed like a never-ending supply of stool continued to drip into the bed. I dipped disposable washcloths into a basin and started to clean him up. Twenty washcloths later, I had finally cleaned up his bowel movement. I was the Queen of Feces.
Kate opened the white post-mortem bag and slid it part way under Mr. Smith. We turned him flat and then towards me, and Kate pulled the bag out on the other side. She put a clean gown on him and I tied one tag to the bag and one to his toe. Do I tie a knot or a bow, I wondered. Do I loop it through instead? I opted for the bow, it somehow seemed gentler. The slippery-smooth nature of the string prevented the bow from really staying tied, though, so I ended up double-knotting it. So much for that.
We were done. He was ready to go.
Goodbye Mr. Smith. I closed the zipper.