Posted by: medicblog999 | May 5, 2010

Compassion, sympathy and empathy

compassion-caring

My last post,‘A Sons Goodbye`, really seems to have struck a chord with many people both reading on this blog and those that found it through the JEMS Facebook page.

To be honest, I wrote it to share the experience of being there and just being a bystander as someone goes through such a huge life changing experience. One which many of us have already had to deal with, the death of a parent.

What I didn’t expect was so much focus on what I actually did and the discussions that have occurred on the JEMS page about the lack of training and awareness of how to actually handle situations such as these.

What I did to help John, by placing his dad back into his bed etc, is just something that I have always done where ever possible. I have on many occasions, along with crew mates carried deceased loved ones back into bed (making sure that they are on their own side of the bed!).

If at all possible I will go as far as possible to make the room tidy and presentable so that as family arrive, as the invariably do, they do not get the shock of seeing their mother or father lying wrapped around the side of the toilet in the position that they died in.

There are obvious scenarios where this isn’t possible to do; the suspicious deaths, the working arrests and the unfortunate individuals who have laid undiscovered for a while and those that are rigored to the point that it would look more macabre to move them than to leave them in place.

I had an early interest in death and dying in my health care career. During my nurse training in 1992, I started to do some voluntary care work at a local hospice unit, and very quickly found my niche in caring for those who are facing their final journal in life. It was in this job that I first heard a phrase that I still am fond of to this day to describe a patient who is expected to die sooner rather than later, T.O.R.

There are many acronyms used, nearly all of which are disrespectful to the patient, but this one, I liked. Any Ideas what it stands for? ………

Taxiing on the runway to heaven.

To me, that sums up what is happening, they are slowly passing through the last parts of this life and are getting ready to move off into the next phase, whatever and wherever than may be, depending on your beliefs and faiths.

I continued working at the hospice on days off for the next 18 months, and once I registered as a nurse, I moved down the country to a clinical oncology ward in Derbyshire.

I always remember walking on the ward and being told by one of the carers that I was

“Too young to do this job”

Of course, being young (ish) and full of myself, I knew that I could do it and do it well, which I believe I did, up until the point that I did realise that I was too young. Being around so much death became exhausting, but it also left me with a profound respect for this final journey and the impact that it has on the patient’s family. I learnt various things that can be done to help the family and to make the transitional period a little less traumatic that what it will always be.

After a while, I moved on in my nursing career, and eventually made the jump to the Ambulance service in 2000 and have never looked back. But my experiences remain with me and shape what I do whenever I am privileged enough to be in this situation.

So, as I walked into Bills room and saw him lying on the bed and saw how John was acting, I knew that there was something to be done. Something simple that will make all the difference in the immediate aftermath of the event.

It wasn’t a big grand gesture, just a simple thought carried through to completion.

Which brings me to the main theme of the discussion in the comments, that as medics we are not taught how to be compassionate, and how to do the important things to help a family through the immediate time following the discovery that their loved one has died.

Many commenters’s, including myself stated that this is something that cannot be taught, or more specifically, compassion cannot be taught.

I still believe that, but I also believe that knowledge and understanding can be shared with medics and pre hospital care providers to allow us all to become more empathetic and sympathetic to the needs of those left behind.

If you have been fortunate to have been teamed with an exceptional paramedic or EMT in your career, you will most likely have picked up on some of these things anyway. Learning from good examples cannot be over emphasised in the pre-hospital environment. Exposure to caring and compassionate co-workers inevitably rubs off on others to a greater or lesser degree.

What’s important is to recognise it happening and reflect on your own practices and routines when you find yourself in these situations.

Is there anything more that could have been done?

Was the situation beyond your control? (i.e. suspicious death, decomposed or rigored body, or the family not wanting their loved one moved)

Did you act the way that you would want a medic to act if you found yourself in the same situation.

Did you care for the deceased patient with dignity and respect?

And finally, did you CARE for those that were left, or did you just do your job?

Advertisements

Responses

  1. “If you have been fortunate to have been teamed with an exceptional paramedic or EMT in your career, you will most likely have picked up on some of these things anyway. Learning from good examples cannot be over emphasised in the pre-hospital environment.”The first non-trivial death I came across on the road (on my first A&E shift, as well…) I was really lucky to be working with an absolutely fantastic paramedic and EMT. I learnt far more by example on that one job than you possibly can from years of training. Nothing clinically (it was fairly simple in that respect), but more about dealing with the patient, the relatives, the bystanders. In addition to that, they covered dealing with yourself – leading by example, they were able to motivate me into working just be the way they acted, and taught me how to let out the emotions after the event (and not kick the next time waster out the back!).A good partner is massively underated.

  2. My daughter's first trip out in a real ambulance (as opposed to Red Cross events) was with you Mark. You took her to her first suspended – I remember her telling me that. She has nearly finished paramedic training so has been working for less than 1 1/2 years on the ambos and has already had 4 letters from patients thanking her for her compassion/ thoughtful care of a patient or their spouse in similar situations. I feel very privileged that she (like her sister who is a nurse) has this gift and is in a position to use it – a desire that was confirmed by her trip out with you. Thank you.

  3. remember how job search/training experts say you can tell a lot about people by how they treat their waiters, other people's secretaries, etc.? it's not a difficult leap from that to judging your co-workers based on how they behave on calls, especially when there's a death as well as surviving family members. considering how long we've been doing this, it's truly a shame that most crews don't do so well on such calls.

  4. As CFRs don't usually work with a partner (at least not where I am) it's hard to pick up these soft skills by example. I'm also in the position that I can't really say someone's dead, but I'm not going to try to resuscitate a body in complete rigor.A few weeks ago, I had a spate (well, three) of calls where the patient had obviously been dead for some hours. First on scene in all these cases, I did the best I could for the rellys but I'd have loved a little bit of info on what I can & can't do/say before the paramedic arrives.

  5. That really sounds like something you need to feed back to the clinical team for the trust you are attached to.You should really have clear and specific guidelines for what you can say and do.

  6. As CFRs don't usually work with a partner (at least not where I am) it's hard to pick up these soft skills by example. I'm also in the position that I can't really say someone's dead, but I'm not going to try to resuscitate a body in complete rigor.A few weeks ago, I had a spate (well, three) of calls where the patient had obviously been dead for some hours. First on scene in all these cases, I did the best I could for the rellys but I'd have loved a little bit of info on what I can & can't do/say before the paramedic arrives.

  7. That really sounds like something you need to feed back to the clinical team for the trust you are attached to.You should really have clear and specific guidelines for what you can say and do.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Categories

%d bloggers like this: