Thread by @psirides

‘‘We Are Strangers Walking Into Their Life-Changing Event’’
This paper on paramedic experience of death is eminently quote-worthy. So I will:
jpsmjournal.com/article/S0885-…

'The importance of understanding a family’s perspective was described in
these words: ‘‘What might be considered routine in
EMS is the worst emergency in the whole world for
the family.’’ '

'The importance of understanding the environment was most
simply described by the participant who explained
‘‘We have to remember that we are in their zone.’’ '

'At the ED they have the luxury of saying ‘‘OK family,
you wait in the waiting room.’’ We have family in on
every call.'

'I’ve had people say ‘‘You can make her more
comfortable in a hospital.’’ No, you’re not making
her more comfortable, you’re making you more
comfortable. That’s all that is.'

'Some families are very calm. They’ve reached that
point where they’ve said their goodbyes and they
understand what’s going to happen. Others are
irate, confused, not ready for the end of life. Usually you can tell in 5 seconds.'

'I can walk in the door and the patient is either
arresting, about to arrest or has arrested and someone says, ‘‘I have this form’’ and they hand you a
DNR. ‘‘So he doesn’t want anything done.’’ ‘‘No,
you’ve got to do something.’’ '

' When a person makes the decision the family needs
to be told so when we show up and don’t do anything it’s not because we’re cold hearted; it’s
because we’ve got to follow the patient’s wishes. '

' When the patient is able to make decisions,
conscious and knows what’s going on and
they say one thing and the family is saying another
we have to go by what the patient wants. ‘‘I can’t just take your loved one, that’s kidnapping. If they don’t want to
go I can’t force them .’

' I spend more time at the end of life working with
the family than with the patient. I explain to them
what we can and can’t do. The family doesn’t
know, they’ve never had Mom die before. '

' It’s the emotion of the family that is the toughest part.
I know what to do if somebody dies. It’s dealing with
the emotion of everybody else that is hardest. '

' It has been recommended that we let the family see
everything we do so they won’t question why you’re
not bringing them to the hospital and if you explain
that it’s the same thing that they would do in the
ED. If we can’t get a pulse back there is no hope. '

<the end>