Bunking with bodies...EMS station/Morgue

[Riblett]

Our main station is a medium sized station with two bays, small living quarters, supply area, and two small offices. A few months ago the county added on to the building a temporary mortuary holding area. It houses a two body fridge. Bodies are placed there temporarily from the scene. They are later are moved either to the funeral home or the medical examiners office in the neighboring county. The two ambulance bays separate the living quarters from the morgue and the adjacent supply room.

I am not trying to be funny, but I really find this disturbing. Maybe I am still immature, but I just plain don't like sharing my station with the mortuary. It creeps me out, for lack of a better description. I don't like going into the supply room or even the bays at night alone. It is not like being based at a big hospital with a morgue across the hospital or in the basement. It is especially psychologically disturbing to have a bad a trauma arrest, then have to bring them back to your station with you and stay there with the person. I don't feel like I have any real closure from these calls. I can't separate myself from them when the call is over. Sleeping on those nights just doesn't happen.

I have never been afraid of dead bodies. I have been around them, worked on them in resuscitation efforts, and put them in the body bags. I have seen several autopsy videos in paramedic school, which did not bother me in the slightest. I can't explain it, but something changes (at least in my mind) after death is determined and resuscitative efforts have ceased. It just isn't the same as working a code on a newly dead person. I learned in my psych courses that most humans have an innate aversion to the dead, thought to be left over evolutionary programming to avoid the spread of disease. I have no other explanation for feeling like this.

I really hate going to work at this station. I have nightmares about it. I may have to find another job because of this, and I have been working here for almost two years. To make matters worse, several years ago there was an incident with this agency where a trauma arrest was later determined not to be dead (no jokes or details please). Long story short it was very dramatic and completely changed the lives of the medics involved. I was not involved, but those who were have to deal with that every day and are still haunted by it. The mortuary facility here is especially disturbing to them, as they are constantly questioning if the body in the next room is possibly still alive while they are trying to go to sleep. Does anyone want to weigh in on this situation? Any advice or similar experiences? Am I blowing this out of proportion? Should I run off and get a psychiatric evaluation or something?

[akflightmedic]

Maybe I am still immature, but I just plain don't like sharing my station with the mortuary. It creeps me out, for lack of a better description.

Yep, I agree. Definitely immature, you said it first. It is a dead body, you are in EMS. Circle of life and all that, sheesh...these were living beings a few minutes to a few hours before they got placed in your freezer. I think you are missing the mindset of RESPECT post mortem. The way you describe your feelings, it seems to be you have none for them.

I don't feel like I have any real closure from these calls. I can't separate myself from them when the call is over. Sleeping on those nights just doesn't happen.

Do you think they are experiencing closure...other than the freezer door?

Not being able to sleep and not being able to separate your self from calls and victims is very disturbing to me...if you were my partner, I may have already notified the supervisor or EAP or something.

I really hate going to work at this station. I have nightmares about it. I may have to find another job because of this, and I have been working here for almost two years. To make matters worse, several years ago there was an incident with this agency where a trauma arrest was later determined not to be dead (no jokes or details please). Long story short it was very dramatic and completely changed the lives of the medics involved. I was not involved, but those who were have to deal with that every day and are still haunted by it.

As they should be, but why are you?

The mortuary facility here is especially disturbing to them, as they are constantly questioning if the body in the next room is possibly still alive while they are trying to go to sleep. Does anyone want to weigh in on this situation? Any advice or similar experiences? Am I blowing this out of proportion? Should I run off and get a psychiatric evaluation or something?

Way out of proportion!! Pysch eval, maybe not yet...but soon.

Seriously, maybe you need to dig a little deeper and learn to cope with this.

[Arctickat]

I'm thinking AK is being a little harsh. Not everyone is capable of disassociation as well as he is and not everyone can be like him. I feel for ya Ribett, I really do. If the morgue had no relevance to the patients I cared for I wouldn't consider it an issue, but being forced to bring my deceased patient back to my place until the funeral home can come get the body is just disconcerting.

How long are you typically stuck with these bodies? Some medics, such as yourself, may be unable to "switch off" after the call and the lingering feelings of the "what could I have done differently" guilt syndrome would tend to be magnified when forced to keep the deceased with you rather than have the opportunity to be able to turn your back in the hospital and move on to the next call.

Discuss your issues with a professional, We are not psychologists. I believe you have perfectly valid reasons for being uncomfortable at this station. As you said dead bodies don't give you the heebie jeebies, but having been involved in their care, then taking them home to my place would be a psychological burden for me as well.

Can you switch stations? Discuss options with management? Even something so minor as taking your deceased patient to a different location may address the major issue. Are you unionised? Not that I'm sure they could help, but it may give you some support if you explain your reasons.

[VentMedic]

Welcome to the world of Respiratory Therapy. Almost every department I have ever moonlighted in has been next door to the morgue. Usually this is because that part of the hosptial is the only place that has the room for all RT equipment.

If is a litttle strange to have a body waiting for entry into the refrigerated unit parked between the life support equipment. We may have as many as 2 - 4 bodies parked in the hallway at one time waiting for their place in the cool, funeral homes or the M.E office. I find myself politely saying "excuse me" as I manipulate the stretchers to enter my office. Sometimes we will hear knocking on the wall which we share with the morgue. We just tell the new RRTs it is the patient who they blew off doing their last treatment.

[akflightmedic]

We just tell the new RRTs it is the patient who they blew off doing their last treatment.

Huh???

[Chief1C]

The mortuary facility here is especially disturbing to them, as they are constantly questioning if the body in the next room is possibly still alive while they are trying to go to sleep.

That has got to be one of the weirdest things I've ever read. I think you should look for a new place to work. Maybe a station with out a morgue. Or.. have a therapy session with a mortician, they live with the dead.

Then again, you could always pull the body out, and check for a pulse, before you go to bed. Do a little CPR, just in case.

[Dustdevil]

Hmmm... this is an interesting thread.

At first I was like, "get over it". My first EMS job was in a funeral home, where our bunk room was very literally right next door to the embalming room. Across the hall were all the viewing rooms. There were two to six bodies in the building with me on any given night. At first, it scared the hell out of me too. But you get over that pretty quickly if you are determined to. My point is really that, when it is part of the job from day one, then you are probably more likely to get over it quickly than when it is something that is thrust upon you after the fact. I mean, we knew it was part of the job when we signed on, so we were determined to deal with it or find another job. Conversely, this is something that you worked for a long time without having to deal with. It was not part of your job from day one. So now you have the attitude that it is something that is being unreasonably asked of you. So yes, I can see where the attitude may be significantly different.

I wasn't sure I agreed with AK at first, but now I am in full agreement with his point, if not his tone. I believe he was suggesting that you not make this all about you, and I fully agree. The fact that you do not wish to share your "space" with the bodies is indeed a sign that you do not fully respect them. Not saying this as a way of criticising you. I'm saying this as a way of showing you how you can change your attitude to better deal with the situation. Those bodies did not ask to be brought back to your station. It sounds a bit like hating on the black kids who did not ask to be bused across town to your school. I believe one of the better ways to deal with the situation is to simply try to better understand the situation and to adjust to it with acceptance.

Another way to help deal with it is to remind yourself that you are not a child. That you are not weak. That you have chosen a difficult profession, and that you posses the intellect and maturity to cope with sometimes unpleasant situations. We've read your posts here for a couple years now, and we know this to be true. Prove it to yourself and you will not only come to deal with the situation, but you will feel better about yourself -- and the dead -- for having done so.

It gets easier. Those medic and medical students who got sick at their first dissection are not still doing so by graduation. Like you said yourself, it is a natural aversion. But experience conditions one to move past aversions. Are you still scared of the things that scared you at age 3? Of course not. It is a temporary phase. If you get stuck in such a phase, unable to move out of it, then AK is right; psychotherapy is in your future. Not because the county is abusing you, but because there is something in your psyche that is short-circuited and not allowing you to adapt in a mature way.

I wish it were as easy as standing up and saying, "this is unacceptable, and I refuse to work under these conditions". And heck, it might be that easy! The county might just agree with you! After all, I agree that they were wrong to just stereotypically assume that "medics love gross shit, so they won't mind". But I seriously doubt that such a complaint would come to a favourable resolution for you. And you've worked too hard to get where you are today to piss it away on what is really a very trivial matter in the grand scheme of things.

This is a test, Riblett. It is a test of what you are made of. It is a test of your maturity. It is a test of your adaptability. It is a test of your professional commitment. It is a test of your intellectual ability to rationalise the situation and deal with it in a positive way. Your response should be to meet those challenges and prove to yourself, if no one else, that you have what it takes to succeed under adverse conditions. You'll feel a lot better about yourself if you do that. And your employer and co-workers will feel better about you too.

If this is absolutely something that you cannot move past and deal with, no matter how hard you try, then I agree that it is time to talk it out with a professional. Not as an admission of failure, but as part of your commitment to do whatever is necessary to deal with the situation. Nothing wrong with that. In fact, it is admirable. But do not let yourself admit defeat on this matter simply because "I don't want to".

Props for the courage to bring this matter up for public discussion! I have every confidence that you will learn to deal with it.

[Riblett]

Thanks to everyone for their feedback so far. I would like to clarify a few things. I am not really sure why I feel this way. I have never been uncomfortable around the deceased on scenes (which was the limit of my exposure to them) before. It is not the same sort of childish fear you have of the dark. I am not laying there afraid they are coming out to get me or anything silly like that. It is not even really fear, more of an uncomfortable feeling. But I certainly think maturity is a factor here. And it is certainly not that I do not respect the dead. I can see your point AK, and why you might get that impression, but I disagree. I believe that I have the utmost respect for the dead and their families. I have many times tried to make a patient more presentable after death to make things easier on the family to view them. I had zero uneasiness and never thought twice about it. This uneasiness applies only to bringing them back to the station and sharing the facility with them for what is usually the rest of my shift.

Perhaps separate myself was the wrong choice of words. I guess maybe having difficulty turning my mind off from the call is a better explanation. It is much more difficult to get away from the what-if's when the body is in the next room for the rest of your shift. The sense of uneasiness is exponentially increased it if was my patient. If I was not involved in their care, it is like I know they are there and I don't really like it, but I just try not to think about it.

In the county I started out working EMS, once death was determined we turned the scene over to law enforcement and left. A separate service came in and bagged, tagged, and transported. For many of you older and more experienced medics, you have dealt with post-mortem issues since the start of your career. You knew from day one that it was part of the job. Like you said, some of you real Johnnies and Roys started out when EMS was breaking away from the funeral home services. This sort of thing was never really a part of my job until now. That is not to say that it should or shouldn't be, just that it wasn't. And all the sudden not only do I have to bag & tag, but transport them in my rig back to my station. So this is completely new to me. You are right with the fact that I am indeed not used to them in what I consider to be 'my space'. Perhaps I am trying to make this all about me when it really should not be. Considering my word choice of "I have to transport them in my rig back to my station."

I am willing to entertain all possibilities. Perhaps a better dissociative mechanism will come with more experience. Throwing a hissy fit and say that I am not going to deal with this is simply not an option for me, personally or professionally. This is really my first real setback like this so far. Besides a moderate dislike for childbirth, I never had any aversions or weak stomach issues. When my fellow medic students were learning to deal with blood, needles, trauma, death, chaotic scenes, etc, I was happily waiting for graduation. As far as AK's question about why the trauma arrest incident from a few years ago bothers me, I don't really have an answer. I did not work there until a couple years later, but the stigma is harsh and lives on. For a long time after the incident when I told people where I work, there was the only half-joking question of "Did you put any live folks in body bags lately?" Maybe a factor, maybe not.

[Timmy]

I find this strange, odd even. I very much doubt any EMS station in Australia would house dead bodies. EMS has absolutely no relationship with any form of funeral home or death related storage facility let alone working as a paramedic out of one and sleeping there! I don’t even think the ambos transport dead bodies, if they do it would be a very rare occasion. Not even my hospital keeps the deceased patients, they got straight to the coroner or funeral man for storage.

You may find bodies being stored in outback/remote medical clinics but that would be the only place to store the body within hours and hours. From an Aussie perspective, this is very morbid, even unheard of.

[akflightmedic]

Perhaps separate myself was the wrong choice of words. I guess maybe having difficulty turning my mind off from the call is a better explanation. It is much more difficult to get away from the what-if's when the body is in the next room for the rest of your shift. The sense of uneasiness is exponentially increased it if was my patient. If I was not involved in their care, it is like I know they are there and I don't really like it, but I just try not to think about it.

I do not understand the what ifs...they do not exist for me.

I do the best I can with the knowledge and experience I have. If there is something beyond my control, it is not up to me to "what if" it as that is just not logical. It is what it is...