Heartbeat March 2020

Inside the mortuary – taking care of
our patients right to the end
Jessica Arnold, Mortuary Service Manager is one of five colleagues who perform post-mortems at
our Trust
When many of us think of a mortuary
we are filled with dread and fear often
imagining what it must be like to be
surrounded by death. However, when
you meet our colleagues who work
in the mortuary at City and Sandwell
it is somewhat reassuring to see that
the mortuary is a calm, even homely
looking place aimed at making loved
ones feel at ease during the most
difficult time of their lives.
Heartbeat caught up with our Mortuary
Service Manager, Jessica Arnold who told
us more. “People often have
misconceptions about the mortuary and
what we do – our aim is simple – patient
care. We look after patients who have
passed away and ensure they are taken care
of until they leave for a burial or cremation.
We can deal with very emotive cases
but the team are here because they are
compassionate and caring.”
We asked Jessica to explain the flow of a
patient leaving the ward and going into the
care of the mortuary.
She said: “When our patients are brought
down by portering colleagues, part of our
role is to check their paperwork is in order.
We check that the patient has the correct
ID and that all their personal belongings are
accounted for. Patients are also measured as
part of the requirement for the undertakers
who require the measurements in order
to prepare the coffins. There is a beautiful
handwritten register where we write the
patient’s name, date of death and the name
of the undertaker. The information is also
recorded electronically.”
Five technicians make up the team in the
mortuary who all take part in undertaking
post mortems. Jessica explained that not all
patients have a post mortem and it depends
on whether the cause of death is known.
“Post mortems are usually carried out if a
patient dies unexpectedly,” said Jessica. “The
process is meant to piece the puzzle of how
someone died. Our coroner’s jurisdiction has
access to a digital autopsy which is situated
at Sandwell crematorium; it is a scanner that
helps to ascertain the cause of death limiting
the need for invasive procedures. In some
cases the scan can be inconclusive so we have
to carry out a full invasive post mortem.
“As technicians we remove all the organs in
preparation of dissection and examination by
the pathologist. This can sometimes result in
further examination where blood and urine is
collected for further testing in the lab. Once
it is clear how a patient has died, the coroner
can issue the necessary paperwork for a
funeral to take place.”
It’s hard to imagine what it must be like
having to deal with patients who have lost
their lives and their families.
Kulwinder Johal, Clinical Directorate Lead has
recently taken on the overall management of
the mortuary. She said: “Dealing with people
in a bereaved status is very challenging. I am
in awe of how the team take care of our
patients as well as manage the expectations
of loved ones.
PRIMARY CARE, COMMUNITIES
AND THERAPIES
“They often have to have sensitive
conversations with families to prepare
them about what to expect when they
see their loved one.”
Jessica added: “We are not a funeral
home so we are limited as to what we
can do to prepare patients for viewing.
But we do ensure that hair is brushed
or combed and that the eyes and
mouth are shut. The aim is to give the
impression that the patient is sleeping
so we lay them on a viewing trolley that
looks like a bed.”
Kulwinder aims to raise awareness of
the mortuary service and the amazing
work they do. “I don’t think colleagues
around the organisation fully understand
the work and skill that goes into caring
for deceased patients,” she said. “We
have just gone through a Human Tissues
Authority (HTA) inspection and there
is a lot of structure and accountability
required to run a mortuary service.
“We have worked together with our
colleagues including clinical nurse
practitioners, bereavement support
midwives and ward managers as part
of a stakeholder group involved with
the deceased to achieve the standards
of the HTA and deliver a coordinated
approach to the way we care for
deceased patients.
“Together we work to ensure patients
are laid to rest quicker and we also
provide training particularly for the rapid
release process. The rapid release process
ensures that a death certificate is signed
on the ward at the time of death (if
cause is known). A signed form is issued
to the family who will give authority for
the body to be released. The patient is
then escorted to the mortuary by a ward
colleague and handed over straight to
the undertaker. When done right, rapid
release can take up to four hours and is
a great comfort for families as they can
lay their loved ones to rest.”
Jessica commented: “Part of the work of
the stakeholder group is also to ensure
families are supported throughout the
process and where necessary direct
them to services that provide financial
support.”
If you would like further information
or training please contact Jessica on
jessica.arnold3@nhs.net
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