Verification of expected death in the community: role of the community specialist practitioner
In 2019, the Royal College of Nursing (RCN) and Queen's Nursing Institute (QNI) recognised a significant reduction in the number of qualified district nurses (those who hold the Community Specialist Practitioner (CSP) qualification). Community nursing is an evolving role, and, with the role of community nurse expanding, the role of the CSP in supporting teams to adapt to the development of the role is more important than ever. As a leader, the CSP possesses skills in leadership and co-ordination of the team, alongside specialist knowledge of the provision of nursing care in community settings. This article seeks to explore the hidden practice of verification of expected adult deaths by registered nurses and how the CSP role is integral in developing and embedding this skill within a team.
The Nursing and Midwifery Council (NMC) (2018) highlighted registered nurses' responsibility to ‘recognise and respond compassionately to the needs of those who are in the last few days and hours of life’. This can be considered in accordance with the North West End of Life Care Model (NHS England, 2015), which defines end-of-life care as a process that continues beyond the death of the patient. This model supports nurse-led verification of death where possible, with nurses best placed to respond with compassion and to maintain responsibility for the patient and their family after death has occurred.
It is relevant to recognise the difference between verification and certification of death. English law states that verification of an expected death does not need to be completed by a doctor (British Medical Association, 2019). The Royal College of Nursing (RCN) (2019) expands on this definition, describing verification of death as the process of confirming that death has occurred. Hospice UK (2019) further elaborates on this, adding that a nurse verifying death would also clarify the identity of the person who has died, note any implantable devices and make relevant notifications of any infectious diseases. Hospice UK (2019) then continues to describe certification of death as the completion of a medical certificate by a registered medical practitioner, detailing the cause of death as required by the Births, Deaths and Marriages Act (1953).
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