Hutsy Posted September 21, 2011 Posted September 21, 2011 Picture this. A young mother is at home breastfeeding her child. They came home from the hospital only four days ago. Dad just came home from work, and is standing in the hallway. Mom realizes the baby turned pale and gets worried. It is unresponsive and has stopped breathing. It's heart has stopped beating. Panic grips them both as dad rushes for the phone and mom bursts out in tears. When I get there personell from the air ambulance are doing their very best to save the child's life. They're at it for over 90 minutes, to no avail. As they work on the baby I am put in charge of taking care of the parents. They are extremely worried and scared, obviously, and mom passes out at one point. They ask me what is going on, will their baby make it? What do I tell them? I've gone through this scenario probably a hundred times in my head, and yet I have no idea what to say, except, "they're doing their absolute best", or something along those lines. But that's not enough is it?
Just Plain Ruff Posted September 21, 2011 Posted September 21, 2011 Talk to them, don't treat them like idiots. This is the absolute hardest thing any parent will have to face and just talk to them and answer their questions, honestly. If they ask if their baby is dead, do not say yes until you know for sure from the crews. When you find out that resuscitation has ceased then someone from the team needs to be there with you. If you have never done this before then you need to be paired with someone who has. You should not be the one to tell the parents their baby is dead if it's your first time in this situation and hopefully the crews won't put you in that position to be the one. I learned from a very seasoned medic how to do this and he said this, watch it done a time or two and then you will know that no matter what you tell the parents they won't really hear you anyway. Their grief will be overpowering and you just being there, holding their hands, or hugs if allowed by the parents work wonders I also am a firm believer of allowing the parents to hold their child one last time unless of course it's a crime scene. There is no excuse for refusing to allow a parent to hold their child one last time and I've always deferred to law enforcement on the crime scene issue but if no crime scene then the parents get to hold their child. You will never forget your first infant or child death. I can see my first, second and third dead child's face as plain as day even after 20 years. Can't remember the full circumstances but I do remember. VERY tough all around. 4
systemet Posted September 21, 2011 Posted September 21, 2011 That was great advice. I just want to add that when you're faced with this situation there is nothing you can do or say that is going to make it better. It isn't going to be pleasant. The only thing you can do is try and be as professional as possible and not give them false hope.
Hutsy Posted September 21, 2011 Author Posted September 21, 2011 Thanks for the great reply, Michael. That helped a lot. I have found that it is not necessarily the patient that gets to me, with one body part here and the next across the road, it's the sorrounding circumstances. How the patient's next of kin reacts to their loved one's injury/death/illness and so on. Will there come a day when I find myself laughing for no reason, or bursting out in tears?
Just Plain Ruff Posted September 21, 2011 Posted September 21, 2011 Thanks for the great reply, Michael. That helped a lot. I have found that it is not necessarily the patient that gets to me, with one body part here and the next across the road, it's the sorrounding circumstances. How the patient's next of kin reacts to their loved one's injury/death/illness and so on. Will there come a day when I find myself laughing for no reason, or bursting out in tears? depends on how you compartmentalize and deal with this job. If you take it home with you, if you think about it every day, think about the bad things and forego thinking about the good then you will be in for a long and depressing career. I always have tried to keep work at work and home at home but that's impossible at times. it helps to have a good sympathetic ear of a spouse or partner(not work partner) that you can talk to away from work. You will bring it home with you at some point. The way you deal with it is what makes or breaks you. yes, You may indeed find yourself laughing out loud at something or crying at times. It's all in the line of work and being a guy you should find no shame in crying like a baby when something truly hurts.
DwayneEMTP Posted September 21, 2011 Posted September 21, 2011 A couple of thoughts.... First is that you can spend some of that time reviewing the history with the parents. Normal birth? Any issues since? Any meds? What happened step by step leading up to this? They gave some of this information to the arriving crew, but it was probably disorganized in their heads and and was focused more on getting the crews to do the 'important' stuff instead of talking. You can find a lot of new and valuable information at this time as well as give the parents something productive to do while they watch the code. Second, parents, even in this situation, can smell bullshit a mile away. You need to be focused on them. Not on whether or not you're going to do or say the wrong things. If you're worried about you they will see that in a second and it will make them really mad...understandably, right? To this day my favorite call was helping an attack victim during my clinicals. I could hear my preceptors and the cops laughing and making fun of me from the doorway for 'being such a pussy.' But man, that is one of the calls that changed me as a medic forever. She was better for it (I like to believe) I certainly was better for it, an neither of us was the worse because a bunch of assholes thought that I should have been able to see that she was just a whore that didn't deserve consideration. Everyone counts or no one does. There are very few people that are good in this situation and most of them have done it a ton or gone to school for years to know how to deal with mentally/emotionally damaged people. Most of us are neither of those, so we have to do the best that we can. Also, I can tell you with nearly 100% accuracy that those that I've been around that brag about being 'really good at it?' They're not. They are bullshitting themselves. And don't have a strong need to fill the silence with mindless chatter. Watch their faces. What are they focused on? Ask if they need it explained. Mom looks faint? Get her a chair. Offer both a drink of water as the catecholemines are going to cause their mouths to be dry early on. Simply never forget that these are not people that you are sharing this experience with, from a professional point of view, they are your patients. Love them, and take care of them, but do so from a reasonable, professional distance. Dwayne 1
Asysin2leads Posted September 22, 2011 Posted September 22, 2011 That's pretty well covered in PALS and PEPP texts, if I recall correctly. Go check them out and get back to me.
PCP Posted September 22, 2011 Posted September 22, 2011 All great advice! As a parent who has lossed a new born child. I would not wish this upon my worst enemy! What ever you tell the parents make sure it is the truth and remember when you tell them be ready to comfort the parents the best you can. Never tell them that it is going to be okay or you know how they feel. Tell them you are sorry for their loss, hug them if needed, ask if there is family members that you can contact for them. Let them grieve in their own way. They may scream at you,hit you, fall to the grownd, pass out, or not say anything. Just remember it is not your fault and that you and your partner did everything that could be done. Before leaving just make sure there is someone else there for the family as they should not be left alone after such a loss. Just never lie! Brian 2
Vorenus Posted September 22, 2011 Posted September 22, 2011 If they ask if their baby is dead, do not say yes until you know for sure from the crews. Yeah, but I`d slowly prepare them for the possibility - like " they are doing all they can, but it`s possible that X is not going to survive". Explain them about SIDS and that it`s not their fault.
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