blaze1306 said:
So it seems the first time was as an MS 3? Thats seems a little early in medical training, but if i'm going into EM i'd rather get used to the idea earlier rather than later. The four step method seems to very useful. I do have a question about the word "die". Does that seem to work better than "passed away"? I know your job is not to soften the blow but is there really a lot of confusion at the notification?
No, you should tell them they "died."
I disagree with some of the others, it does get easier with time; maybe it's because I kill too many people.
You alleviate most of the physician stress when you realize that there's no "good" way to rip someone's life apart by telling them a loved one died, only a humane way.
I also usually allow 2 people max to be present when I give news; I don't go out into a crowd of 15 people to give notification, it can and has become a mob scene. I am especially cautious with trauma patients. I usually have them put in the grieving room and kneel in the doorway and tell them (so it looks like I'm being the good doctor by "sitting down") where I can also bolt out if things go nuts. Remember: emotionally trying times + emotional immaturity do not make for a great mix.
I usually use a similar pattern as described:
"What have you been told so far?"
"When he came in, he was not breathing.."
"His heart was not beating..."
"We did XXX" (quick)
"And I'm sorry to tell you, he died."
I don't put a lot of effort into giving gigantic explanations after that, because almost nothing is processed.
I offer social work and usually a "I don't think he suffered" if it's a reasonable assumption (SAH, trauma)
mike
mike