References
Paramedics' experiences with death notification: a qualitative study
Abstract
Objective
To explore paramedics’ experiences and coping strategies with death notification in the field.
Methods
Urban and urban/rural paramedics participated in four focus groups across Ontario, Canada.They were asked about their experiences communicating death notifications and the support they received. Transcripts were analysed using the constant comparative method. Themes were generated inductively.
Results
Twenty-eight paramedics participated. Four themes emerged: the practical aspects of deathnotification, how paramedics acknowledge the emotional toll, how they manage the emotional toll, and the support mechanisms they used. Communicating a death notification is stressful and paramedics’ personal attitudes to death influence how they communicate a notification. Switching roles from clinician to supporter is challenging. Deaths that are unexpected, traumatic, obvious, involve children, with which the paramedic identifies, or are the paramedic’s first experience are especiallystressful. Paramedics receive support by talking to peers and using informal support networks. They prefer support from people who have had similar experiences.
Conclusion
Paramedics’ experiences with death notification are stressful, challenging, andrewarding. More formal support for paramedics is necessary, especially when the nature of the death is distressing. Our study suggests that further training is required to increase paramedics’ comfort with this challenging communication.
Every year,30000 cardiac arrests occur outside the hospital in the UK (Nolan et al, 2010). Paramedics are required to pronounce patients in the field in 53–61 % of out-of-hospital cardiac arrests (Roth et al, 1984; Aprahamian et al, 1986). As such, paramedics are frequently required to communicate death notifications to the bereaved in a pre-hospital setting (Norton et al, 1992; Regehr et al, 2002;Smith-Cumberland and Feldman, 2006). In a pilot study, paramedics perceived death notification to be even more challenging when communicating notifications for deaths that were traumatic, unexpected, preventable, involved children, within a situation they identified with, or when it was their first experience (Douglas et al, 2011). Paramedics may be the only source of support for survivors after a death occurs in the field and balancing patient care with delivering calm, compassionate support can be challenging (Schmidt and Tolle, 1990; Smith et al, 1999).
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