Death and Dying

Dealing with death is never easy on either side of the fence. I guess I’m lucky in that I’ve not lost too many close relatives or friends. About a week before Thanksgiving in 2004 I lost my gramma, a woman I miss every single day. She was my pal, my confidant, my mentor, everything. She took care of me and I tried to take care of her in return.


She’s the closest relative I’ve ever lost.


In the business of EMS we deal with death frequently. Mind you, it’s not necessarily every single day or shift but in some settings that may be the case. In our small area we see some but not often. We have some from old age, from overdoses, from car wrecks, from other means. We aren’t a homicide mecca around here but we do have one or two a year.


Some of these deaths come from homes. Others come from a retirement home or community, others an ECF, highways, roadways, or even one of our three local prisons. We get the gamut from everywhere. Some old, some young, some too little to walk or talk.


Each person deals with death and dying in their own way. Each has their release. Each handles the scene or the people in their own way. The first time I did CPR on someone I was 17 and she was in her mid 90s. No problem. The first child I did was in the middle of the school day and she was 13. To this day her mother puts a memorial in the local paper on her birthday so I am reminded of it every year. The first infant death I had was Christmas Day 1991. All three of those times I was asked if I was okay, if I needed to talk to someone, if I was handling things all right. Each time I had no problem. I got upset, I cried on one, I still think about all three as they’re still fresh in my mind even all those years ago.

I’ve dealt with screaming family members, fights by bystanders who were like warring factions, loud noises and distractions from roads, fires, a little bit of everything. Most every time I’ve had to, in some way, deal with the family. Some of those times it’s been “pleasant,” if you will, while other times it’s been a nightmare. More so now than in the past I try to make sure the family is addressed by someone else if not by me. They’re a part of my scene and my patient and they need to be dealt with too. They may need a shoulder to cry on as nobody else is there. They may be too distraught to call anyone. They, like us, deal with death and dying in their own ways that may not mimic the way we do. “Normal” people don’t see death as often as we do nor do they deal with it in the ways we do. They have an attachment to our patients where normally we do not. We may not know them. In a small area like ours we may well know the person or a friend of family of the patient. Usually around here most deaths touch someone on our service in some way, close or distant.

We aren’t nurses who see these patients for an entire 12 hour shift or weeks or months in an ECF and get to know them. We don’t get to know their quirks, their personalities, the way the smiled or looked at someone. We normally don’t know their families and if they were visited or abandoned. We see them for a short time, carry them to the hospital or simply wait for the coroner or local funeral home to come and collect the body.

Some people are in denial. Some people cry hysterically. Some people pass it off as, “it was their time.” Everyone’s different. The one big thing I try to do other than deal with or make sure the family is dealt with is keeping some form of dignity with the patient. If they’re pronounced on the scene we need to let them keep their dignity. I’ve seen scenes before where all the clothes have been ripped off, the crew pronounces them, then leaves the immediate area while others are milling around this now naked dead body. Dignified? Professional? No. If I were a family member and saw that I’d want someone’s head. I’d try to have someone’s job. I wouldn’t treat someone like that and I damn sure don’t want my family treated that way.

I’ve also seen providers lose sight of the picture because they have an attachment to the patient and not provided standard care. Happened? Yep. Understandable? Yep. That’s where the others need to step in and help out, get them aside and let proper care happen.

Probably all SOPs or protocols address DNRs, advanced directives, or living wills. At times the family forgets where they are. They may change their mind at the last minute and want everything done. They may not want anything done yet the patient DID want something done. I’ve seen it all. It’s hard to comfort a patient’s family as we’re pounding on their chests, sticking needles all over the place and pushing all sorts of drugs and putting tubes here, there, and everywhere. We’re working hard in an effort to save people. We don’t always succeed but we give it our best shot.

Medical professionals deal with death. But when it’s us who’s on the other side it’s the same as above. We now become those who may be hysterical, crying, upset, screaming and hollering, lose sight of what’s best for the patient, anything at all. When it’s our loved one everything we know and have been taught kinda goes out the window as it’s now our crisis, our family member, our loss; not someone else’s that we need to console their family. We want someone to console us, to give us a shoulder to cry on, a door to punch, something to help ease the loss of our close family member right in front of our faces.

Remember that we see one side of death and dying. We’re not usually on the other side. If you ever are, God forbid, and experience that loss please remember how you were treated, what you felt, the profound sense of loss and emptiness you feel or felt. The next time you have a patient that dies on you or you are called to work on and you’re around their friends or family, remember those things. Remember what you craved and needed during your event. Remember those things and try to make them feel better, more comfortable; be empathetic. Keep the patient’s dignity intact and help the family all you can. It may be staying on scene to talk to the family, making calls for them, waiting until someone else shows up.

It could be you in that scene. How would you want to be treated? Death and dying is never easy, for anyone. Keep those things in mind and let your best judgment and conscience be your guide.