When a patient dies – navigating your emotions and responsibilities

Dealing with the death of a patient is a difficult but an inevitable part of your profession. In your early years, your emotions can add stress if you are required to certify a death – a responsibility that most interns learn on the job. This factsheet shares tips for navigating this situation

Wednesday, 18 December 2024

Intern staring out of window into distance

Quick guide

Debrief with colleagues and supervisors
Consult a good GP and psychologist if you’re distressed and not coping
Talk to trusted friends and family when you need to
Call Avant for advice on certifying a death

Focus on the facts

Whether you work in emergency or hospital wards, it’s normal to feel some apprehension when a patient dies during your shift, especially if they deteriorate quickly. You might worry you are somehow to blame. This is when you need to focus on the facts. Depending on the situation, a debriefing session is sometimes held and establishing the facts surrounding the patient death can help relieve your stress.

Avoid unhealthy coping behaviours

If you experience a series of patient adverse events or deaths, your mental health may suffer and leave you susceptible to alcohol or substance misuse to cope, or to consider thoughts of self-harm. It’s important to remember you’re not alone and ask for help when you need it – from peers, supervisors, friends, or family.

Seek professional help if needed

Sometimes you need more experienced support to get through a difficult experience, so talk to your GP and consider seeing a psychologist to learn strategies to maintain your mental wellbeing. Your medical indemnity insurer may also provide advice and support right at the time you need it.

What if you are asked to complete a death certificate?

Some interns learn about completing a death certificate on the job, which can be a daunting experience. When you are asked to complete a death certificate, the document you need to complete is a Medical Certificate of Cause of Death (MCCD) or death certificate. This is the legal document used to notify deaths to the Registrar of Births, Deaths and Marriages in each state or territory. To complete a death certificate, you must be satisfied

the cause of death, and
the death does not need to be reported to the coroner.

If you have been treating a patient immediately before they died, or if you examine the body, you usually have 48 hours after the death to complete the certificate or the death should be reported to the coroner. The process and requirements for completing certificates are different in each state and territory. Make sure you understand the rules that apply where you practise. Read the factsheet and flowchart for your state or territory.

Do not sign a death certificate if you are uncomfortable or unable to form an opinion as to the probable cause of death. Also, do not sign the certificate if you think the death should be reported to the coroner. Seek advice.

Call Avant for guidance

If you need immediate help in completing a death certificate and you’re an Avant member, you can call the Medico-legal Advisory Service, 24/7 in emergencies, and an adviser can talk you through the process.