Dealing with Death

Morbid topic I know, however as an individual who works in the emergency department, this unfortunately comes with the job.

I’ll never forget my first patient death as a scribe. During the interview process, they tell you this will be something you encounter. Notice how they say will and not might.

My first patient death was a young man in his late teens. He had attempted suicide by hanging himself and unfortunately he was home alone. He was found by his parents and EMS was called to the scene. Upon their arrival, the patient had a pulse, however it was very brady (slow). En route to the hospital, the patient’s heart stopped and he went into cardiac arrest. Chest compressions were started and the patient was placed in a lucas device to take over chest compressions while they try to get a line in to push medications. When the patient arrived to the hospital CPR had been in progress for approximately 15 minutes. Now normally, if the patient is unable to regain a pulse after multiple rounds of CPR, time of death is called on the patient. In this case, when the patient arrived, CPR continued for another 45 minutes. You can feel the determination in the room. No one wanted to stop pushing meds or stop chest compressions. CPR continued until the family arrived. One more round of epinephrine was given to the patient in hopes or restarting the heart. Unfortunately, it did not.

The sound of the patients mother screams as time of death was called on her child was mind numbing  and shook me to the core. The room was emptied of all staff so the patients family can have time with the body. Any case dealing with children greatly affect the staff, not saying an adults death is any less significant. I remember the physician going onto the ambulance bay to cry, the nurses hugging each other in the break room. I even went into a little side room to cry and pray that God has mercy on his soul. At that time, I remembered back to what we were told during training. It is perfectly okay to cry, however you cannot cry the whole shift. Give yourself two minutes, let it out, go for a walk outside the ED for a minute and then come back and refocus. There are more patients to see and their care cannot be hindered because we’re emotional about a prior case. They deserve the best care we can give them and eventually, seeing death will become more tolerable but never easy.

Today, a fellow scribe experienced their first patient death. I gave them a hug and told them the same things I was told during training. They took the time they needed and was able to head back to work. Like I said, patients are waiting.


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