Case study:

04 August 2008

Psychological impact on care staff of handling patients’ bodies in the mortuary at St Francis Hospice, Romford.

Key points

Staff are suffering psychological effects from frequently handling patients’ bodies in the mortuary as part of the practice of allowing families to see their loved one’s body several times, an audit has found.

The audit, carried out over three months from April to June at St Francis Hospice in Romford, Essex, showed 63 patients died and on average the bodies remained in the mortuary for five days although some stayed as long as 13 days.

During that period the audit showed that one staff member moved patients’ bodies 17 times, while eight staff moved bodies between 10 and 14 times.

Twenty nine staff moved patients’ bodies in the mortuary between one and four times.

Trained nurses had the most exposure to patients’ bodies.

As a result of these findings the hospice is considering introducing restricted viewing for families and friends and raising awareness among staff of the psychological support that already exists but does not seem to be well used.

A pilot period will also be considered during which bodies are transferred to funeral directors as soon as possible.

The audit was the result of issues raised by staff and student nurses during reflective practice sessions and placement evaluations about the handling of bodies in the mortuary.

Over the past four years, senior nurse managers have become increasingly concerned about traditional nursing practice in the hospice, which encourages families to view deceased patients on a number of occasions over several days.

The issue has been raised and discussed with nursing teams at team meetings and away days.

However, there has been a reluctance to consider changing practice.

The hospice sought to enhance staff support and clinical supervision and introduced mandatory reflective practice as part of that development.

The aim of the study was to identify the psychological impact on staff in order to find a way forward and change practice.

The audit team also wanted to assess the level of support and training currently offered at St Francis Hospice in this area and to examine ways of improving this.

The study also looked at the experiences of 47 hospices with similar bed occupancy in the UK and Ireland.

The literature review found nothing that quantified the work nurses undertake after a patient has died or assessed the psychological impact on care staff handling bodies in the mortuary.

There were, however, some useful comparisons to be made. For example 30% of hospices said they move bodies within 24-48 hours of death.

The organisation is committed to supporting staff and finding a way forward on these issues. With this in mind it is planning a further audit in April 2009.