Personal death Emt brain.

[Joker21]

So I watched my boyfriend's mum die on Monday early morning.

It was peaceful, and calm, and she went surrounded by family. But I was uncomfortable the whole time. Because I knew things they didn't. I saw things they didn't. Smelled, heard, felt... you get the picture.

We showed up for an afternoon visit and she was unresponsive, resps 32, labored, snoring.

Cool to the touch, but diaphoretic. Mottling to the extremities. And for me little flags are going off about what's happening to her body.

But boyfriend's family is talking about the real estate market, or shopping or work drama.

We get called in the night because the nurses think it's almost time.

When we show up she's agonal breathing, and I'm watching the apneic periods grow longer.

And his family is talking about what a hassle the cab to the hospital is in Canadian winter.

Her breathing changes and it's smooth and unlabored, but still fast and shallow.
And I try to tell them "Her breathing is changing. I don't think it will be long now." To encourage them to actually notice the person dying in front of them. Boyfriend steps out to use the restroom.

Breathing is slowing, even more shallow now and so I say "I'm going to give you privacy to share with her."

And I leave the room to call boyfriend because I know that she has only moments.

He didn't make it back.

They all commented about how they wish they'd held her hand, or told her they loved her. And boyfriend beats himself up about missing the last moments.

In my job I don't spend hours watching people die. Minutes at most, maybe. And I'm always working to benefit the patient. Slow their death, ease pain, etc.

I'm sure a ton of us have experienced something similar, where your work brain can't turn off when there's a personal medical event going on. I didn't know how to just be girlfriend and shoot the sh*t and comfort and try to understand someone else's pain. I was stuck with work frustration and helpless.

I guess I'm wondering if anyone has had a similar experience they'd share? And how things went in the following days/weeks? Because I am lucky to not know personal loss, or grief. So I'm lost as to how to be supportive for an emotion I know nothing about.

[island emt]

What part of this is bothering you?

"It was peaceful, and calm, and she went surrounded by family.

But I was uncomfortable the whole time. Because I knew things they didn't. I saw things they didn't. Smelled, heard, felt... you get the picture."

Death is a natural process and it sounds like this lady had a fairly easy one.

Did it bother you because you were being clinical and not emotional?

Or because the family was not being emotional?

Is this the first time you have been exposed to life slowly slipping away instead of fast violent painful death?

[scubanurse]

I'm right there with Island. In my current job, we have deaths at least once a week on our unit and I am fairly intimate with the dying process and the plethora of emotions families go through. Maybe you can expand a little on what's bothering you about this and we can go from there.

[Just Plain Ruff]

I've been involved in both sides of the coin, family members and friends family members who have passed.

As a medic, the first couple of these types of deaths I did look at things clinically rather than personally or emotionally, still do to a point, and I realize that the first time can be a significant affront to someone who has not gone through this before.

We need more info as to why you were so affected?

[Joker21]

Yeah as just a 3 year EMT it was my first slow one. And like I said I haven't had to experience it first hand in my own family.

You guys are all spot on. I felt too clinical instead of emotional, and that they weren't being emotional at all.

I don't feel "so" affected. Like 2/10 on the discomfort scale.

Just a new sensation for me I guess

It just seems easier to be part of the care team instead of the watching/preparing for grief side of things.

[Just Plain Ruff]

My thoughts are that you are more discomforted by the family being so disaffected than your personal reactions.

It sounds like this lady was on her way out and it was not an unexpected thing was it? If that's the case then the way the family dealt with it was they way they dealt with it.

I've been involved in the passing of many in my family and friends and it's always more difficult for me to watch the reactions of those said family and friends. You run the gamut of emotions and responses from cold emotional detachment (I never go to funerals, not even family members(rare exceptions)) all the way to blubbering fools crying their heads off.

I was fortunate to be called to a house where a family member was taking their last breaths. The family called 911 because they didn't know what else to do, they were given poor advice by medical care givers as to what to do with grandma when she was on the way to greener pastures.

They produced the valid dnr but our protocols state that once we are there that we have to wait till the patient is dead. So wait we did. We cleared the FD and waited. I got to hear some really wonderful stories and only one person was crying the others were remembering grandma.

I also remember the slow and easy passing of a 3 year old who we were called for, he also had a valid DNR (genetic disorder, fatal) and it was only the childs parents and no one else as they just moved to the area. We also sat around and waited. This was extremely difficult for me but it was also a very good exprerience to be with the family.

You learn things about life and death and that no matter what, you can't get away from it. You do the best you can and I guarantee that this will not be the last time you will be in a situation like this so your take away should be to take this experience and tuck it away and use it for next time and keep adding to your repertoire. I guarantee that even though the family didn't thank you for being there, they more than likely were thankful you were there.

[island emt]

I know this may be hard to understand with your limited exposure to these types of calls.

But sometime the biggest thing we can do in this situation is be there for family members and support them.

Hospice care has become more of the normal than it used to be , so we have many more terminal patients going home for their final days or weeks instead of being in a cold "sterile " hospital room away from their home environments.

Is there a hospice group in your area?

If so they might have some literature and maybe even CEH classes to help you understand the process.

As far as your boyfriend & his family not showing a lot of emotion : Everyone has a different process. Maybe they had all had many discussions of what to expect and knew that this was coming soon. They had already adjusted to this fact and were prepared.

You will encounter some really incredible older folks over your career as they meet the end of their lives. Just a part of life that we all will end up with.

Good luck

Ed

[Joker21]

She'd been diagnosed with Cancer in October so we knew it was coming.

This has definitely been a learning experience for me. They always tell you that people grieve differently but it makes more sense when you see it in front of you. Anger, denial, it's all right there.

Thanks for sharing your stories and support guys, I hope that I get to build my experience base and be a better EMT because of it.

[scubanurse]

I have seen families in complete denial even after clinical death has occurred, I have seen family members cry for hours after clinical death, and I have seen families very stoic after clinical death. I have also been witness to several family members last moments and understand it's sometimes hard to figure out the balance between clinician and family/friend member.

[island emt]

A couple years ago had a very close friend of our family who was entered into hospice care and given less than 2 months to live.

He was a retired 3 star Air Force general who had flown fighters in Korea & Vietnam and had been a POW for a time.

The stories he shared and the wisdom he gave to us all was an incredible thing.

He & his wife were long time friends and customers of ours. he surprised all the doctors and lasted for 6 months longer than they had guessed.

We visited with them regularly and as he started to get weaker we worked with the hospice folks to get him the assistance they needed, from a hospital bed to support counseling for her.

As the time approached and we were down to a few days, we sat and talked about his wishes for the family and how things would happen.

At the last day, we knew his time was near and had his wife call all the kids & grandkids to come say goodbye to gramps.

He stayed with us for another 36 hours until his grandson got here and within 10 minutes of his arrival took his last couple of breaths and peacefully passed.

during that time we all told stories and shared our memories about him and with him.

They all knew the time was coming and tears were shed , but they were all thankful for the opportunity to say goodbye.