Complete Story
12/10/2009
Update on HB 314: Determination and Pronouncement of Death
On Wednesday, December 2, OHPCO/OHCO's Public Policy Coordinator, Susan Wallace, testified before the Ohio House Health Committee in support of HB 314, which would allow registered nurses to pronounce death in the state of Ohio. OHPCO/OHCO was solicited by the bill's sponsor, Representative Ujvagi of Toledo, to represent the home care, hospice and palliative care industries that would be most directly affected by this bill's passage.
In testimony, she explained that under current Ohio law only physicians may pronounce death, though it is common practice for a nurse to evaluate a patient and contact the physician via phone in order to communicate signs of death of a patient and obtain the pronouncement. In some cases, a physician is unreachable or is delayed in responding causing unnecessary stress on the family, and impeding the funeral home to proceed with arrangements. She stated that the bill is an "effective and efficient utilization of expertise and resources," and would facilitate compassionate care at this critical time for families.
Further, Jacalyn Golden, legislative co-chair for the Ohio Association of Advanced Practice Nurses, said the ability for nurses to declare death in a long-term care facility is also important. She said delays could cause difficulties in situations where the deceased shares a room with another patient. Golden said she personally had encountered a doctor who was uncomfortable making a death declaration by phone and had ordered that the patient be taken to the emergency room for a declaration, which was stressful for the family.
Diane Salvador and Jeri Milstead, representing the Ohio Nurses Association, also testified as propnents. Salvador said waiting for a doctors' declaration could create problems for people whose religious or cultural traditions call for prompt preparation of the body after death. Milstead said that as of three years ago, 20 states allowed nurses to pronounce death, and that there had been no opposition from doctors so long as they were still the only ones actually allowed to sign the death certificate, a duty she described as a reimbursable service. Milstead also said that, while it was unpleasant to put it in such terms, delays in death declarations can also tie up hospitals beds, which can be scarce in busy hospitals.
The bill, sponsored by Rep. Ujgavi of the Toledo area, was the result of a University of Toledo College of Nursing class project that identified delays at time of death as a significant stressor for grieving families.
