Shell shoked

[Medic]

Hi all, what did you feel when you first lost a pt en route to hospital?

& when you first went to a morgue?

I experienced it all last night and it got me thinking, will it effect me to the point I lose sleep next time. Will I be able to carry on working, push threw or will I break. It's all new to me so I would'n mind some friendly input.

thanks

 

[Aidey]

I don't know about other areas of the US, but where I am patients do not die in the ambulance. At least legally. They are either declared dead on scene, or at the hospital.

If for some reason a patient is declared dead in the ambulance that ambulance is out of service until the coroner can come and investigate (sometimes hours later). At that point the coroner takes the body to the morgue, or if an autopsy isn't needed the funeral home comes and picks it up directly.

 

[wyoskibum]

Hi all, what did you feel when you first lost a pt en route to hospital?

& when you first went to a morgue?

I experienced it all last night and it got me thinking, will it effect me to the point I lose sleep next time. Will I be able to carry on working, push threw or will I break. It's all new to me so I would'n mind some friendly input.

thanks

Every situation is different. You never know what it is about a call that will effect you. For some, it is small children because it reminds them of their own kids. For others, it could be elderly patients because it reminds them of Grandma.

One thing I find that works for me is to do a defusing after the call. I'm not talking about every routine call, just the ones that gets the adrenaline going. Get everyone you can who was involved in the call and take a few minutes to discuss what had happened. Talk about how you nearly crapped your pants when you discovered that it was as bad as it was. Or how you were glad when the extra help arrived. Can we learn anything from this situation and what can I do better the next time?

Finally, you may want to consider a CISD, not only for you, but your team members who were involved.

 

[VentMedic]

Finally, you may want to consider a CISD, not only for you, but your team members who were involved.

Seek out a professional counselor. There may be issues in your own life that need to be examined as to why this call affected you the way it did or how your perceive death. Your feelings and the way you process the events in your life are unique to you and no one else.

 

[RyanMidd]

Hi all, what did you feel when you first lost a pt en route to hospital?

& when you first went to a morgue?

I experienced it all last night and it got me thinking, will it effect me to the point I lose sleep next time. Will I be able to carry on working, push threw or will I break. It's all new to me so I would'n mind some friendly input.

thanks

Apparently "shell shoke" affects your ability to spell post-traumatically.

Just kidding!

Take advantage of any critical incident stress management your employer offers; you may think there is no benefit, and feel no differently, but CISM is like antibiotics -- you won't know there's something wrong until you stop taking them. You have to take all of it, not just until you feel better.

 

[reaper]

CISD has been shown to be useless. If you are having problems, go to a professional that can help you.

 

[wyoskibum]

CISD has been shown to be useless. If you are having problems, go to a professional that can help you.

I would be interested to see the research on that. Do you have a link?

 

[reaper]

I would be interested to see the research on that. Do you have a link?

I am at work right now and can't do a search here. If you search it on here, we had an indepth discussion on it about 2-3 years ago. There was a lot of links to the studies in that thread.

 

[zmedic]

CISD has been shown to be useless. If you are having problems, go to a professional that can help you.

Depends on how you define useless. The studies I've seen say it doesn't prevent PTSD. But if it makes you feel better to get together as a group with those on the call and talk through it I say go for it, especially if there is someone more experienced to mentor it. I don't think it needs to be a grief councilor. But when I was on ski patrol we had a really bad call and I think it helped the younger patrollers to talk through it as a group with our medical director, who was able to say "you guys did everything right and should be proud of the job you did."

I think there is a role for a discussion somewhere between getting a beer with your partner and signing up to see a psychiatrist.

 

[viccitylifeguard]

my first pt death was when i was a life guard about 8 years ago it was my first time having to get in the water,first time cpr the whole day was full of first. once als showed up we all worked as a team it was amazing watching them push drugs shock and set up iv lines. then i was asked to come with them to continue compressions in the back of the ambulance alli could do is look at my boss a see him give me the thumbs up to go all the other guards were shocked i went. the pt coded according to the medic 5 times on the way to hospital. in to the hospital we went and the doc on duty just yeld "donovan what are you doing ?" all i could say was :doing what ive trained for with a big :censored::censored::censored::censored: faced grin on my face about 45 min later the pt was pronounced deceased. and we prepped him for the mourgue. it was an amazing experience one that i will never forget and dont want to because everytime i think of that morning (july31 2001 at 06:15) i recall the amazing team work of everyone involved and it made me want to become an EMT more than anything in the world .
the only advice i can give you on dealing with your situation is talk if you want to talk find something to relax some say drink it away i prefer smashing cars a the wreaking yard or a nice long bike ride but dont let it start to effect your work life and home life
talk it out to your partner other at the station. what ever you can some times it gets better easier for some than others

 

[Medic]

Today I feel fine, kind of plays om the mind a bit when Im bored. My friend who is a shrink in training spoke to me an just went through a few things how to get over it. My other philosophical friend helped a lot told me the name of what was feeling and how to work through it and instead of been depo about the call you should be happy in the way because you were with the pt in the pt's final few mins trying to help.

The pt did not die in the ambo but was called doa in the er my mistake sorry.

While typing the heading "shell shoked" the 'c' button wouldn't work and I had some thing in my eye you see, every thing was going bad in that couple of seconds. lol

Thanks all this call made me think about hanging up my boots and not getting into the career even as a volly. But I came to my senses and still realized I love the job, I love helping and that stuff is part of the job so I plan to work through it.

 

[Lifeguards For Life]

I would be interested to see the research on that. Do you have a link?

Why doesn't CISM work? It appears that CISM and other forms of psychological debriefing may actually interfere with the natural recovery process inherent in normal individuals. The alternation of intrusive and avoidant thoughts characterizes normal psychological processing following a traumatic event that may be disrupted by this approach to intervention. CISM may also lead affected personnel to bypass established personal support systems (family, friends, coworkers, clergy) usually used for non-occupational-related crises in the belief that the CISM session should be sufficient to alleviate their distress. Furthermore, a certain amount of time appears necessary for an individual to process the psychological impact of exposure to a traumatic event, and no external stimulus or program may be capable of shortening this interval.13

http://publicsafety.com/article/article.jsp?id=2026&siteSection=8

https://www.instructorscorner.org/ViewLink.aspx?lnk=21

http://www.bryanbledsoe.com/data/pdf/cism_debunk.pdf

I have heard from people who have been subject to CISM, that it actually made matters worse.h34r:

 

[VentMedic]

Medical debriefings should not be confused with CISD. We have a regular meeting each month just to review the patients we have transported and we may have one right after a major call where there obviously were some issues. We may get a pat on the back or the whole team will get a butt chewing. These sessions for not for the weak and some here would probably be very offended or their feelings hurt if a medical director critiqued one of their patient runs harshly. The medical directors of the various teams will also be very quick to take you off the team if something really shook you until they can see if you are able to perform your duties without second guessing yourself. Sometimes it will be your own flight or team partner that will ask that you sit out a few transports. Even if one of the medical directors has training/education in counseling, they will not attempt it but will tell you get the appropriate help. The MD's responsibility is to the whole team and the patients. Sometimes problems rise to the surface that have been brewing for a long time. One talk may not be enough and that medical director needs to know if you can do your job.

We deal with a lot of death, including being the ones to pull the plug on patients of all ages, between the ED and the ICUs each shift so the number for the hospital counseling service is always hanging up someplace to remind us there is professional counseling available. It is usually not the duties of the job that crumbles people but a combination of other stresses in their life. We know our jobs and have all received extensive education for counseling, probably much more than what some of the CISD group leaders get, just to deal with the patients and their families. We don't kid ourselves into believing we are experts though. Other professions also touch on death, dying and how to deal with feelings of your own and others during their college education. EMS unfortunately does not have anything in the curriculum that comes close to that.

We put 110 hours first aiders out on the street and expect them to deal with life and death issues when some of them are barely out of high school or even still in high school. Some don't understand why patients die when they have been told in that 110 hours that they are "life savers" when often it is just prolonging the inevitable or you just can't always stop death from happening. Other professions do get some education in that death will happen regardless of your best efforts.

 

[kittaypie]

i've had one patient go from talking and complaining of back pain to full arrest in about 15 minutes. he coded after we loaded him into the ambulance and we worked him up for about 40 minutes en route to the hospital. i still remember everything about the call, especially when he reached up and literally had a death grip on my partner's jacket as we put the gurney's seatbelts on him. it's a really sad experience because you feel like you failed as a medical provider. turns out this guy had a massive heart attack and there was nothing we would've been able to do. they pronounced him quickly in the ER. things like that stick with you but you need to be able to talk about it with someone.

 

[firetender]

Welcome to the Twilight Zone!

You've made the choice to involve yourself in EMS.

You are now on a voyage of discovery.

You have begun working on the line between life and death.

You're actually entering in to a relationship with death. You will come to know it. Impressions you have today will be much much different than a year from now.

Some things will bother you. I think starting to share here is a good thing. You'll see some threads that include people actually working through stuff with the support of others here.

Personally, I'd like you to have a working world where you can actually talk to your peers about your experiences as a human being asked to provide emergency care and transportation for the sick and injured, without being derided or judged for it.

Sometimes you have to look a little to find a space and/or people safe enough to share what you need to. But such things are available.

As you've already seen some circumstances and some times hit hard and linger, others pass quickly, but remember, THEY ALL PASS.

If you think you're there to battle death you're going to lose. Think of it instead as participating in the struggle, and lending support where you can by preparing yourself as best you're able..

 

[Medic]

This forum has helped me so much, good advice on how to deal with it, shows im not in it alone an some times it feels like you are the only one to feel like this. Not true.

Thanks for the help guys. The situation I was faced with nearly took it's toll and forced me to stop. But im working day shift soon( lil more chilled shift) just to kinda ease back in.

Appreciate it guys, ill be back discussing any of my future shockers.

Keep safe and hope to repay you guys n gals in the future.