Coping with sudden traumatic death Dr Tricia Scott PhD Cert Ed RGN RMN Senior Lecturer – Emergency Care Research Lead Centre for Research in Primary and Community Care University of Hertfordshire p.scott3@herts.ac.uk

Aims of the session Assess the relative’s knowledge of the events leading up to the sudden death Select appropriate terminology when giving bad news Express genuine condolence to the relative Recognise the reaction of the relative following communication of the sudden death message Respond effectively to the reaction of the relative following communication of the sudden death message

Ground rules Agree to reflect on personal encounters with SD in the emergency setting Share information about these encounters Remember the confidential nature of the information Engage in open and honest discussion Open door policy

Assess relative’s knowledge of the events leading up to the sudden death Think of a sudden death encounter where you were involved in caring for grieving relatives

Write a few phrases or comments on how much information relatives had about what had happened to their loved one

Select appropriate terminology Write notes on some words or phrases that you might use when talking with suddenly bereaved relatives

Expressing genuine condolence “I’m so sorry” Explain the physiological changes “Death, dying dead” “We’ve lost him” “Gone to a better place” “Fought hard and lost the battle” “Is there any way that I can help you?”

Sensitive conversations Announcing Clinical equipment Tissue donation The condition of the body Post mortem criteria Recording and handing over property Religion and spirituality Death certification

Crying, sobbing weeping Emotional responses Denial Withdrawal Anger Acceptance Isolation Bargaining Crying, sobbing weeping

Which do you think is the most difficult to manage?

Which do you think is the least difficult to manage?

As a carer it is sometimes difficult to separate personal feelings when intense emotions are being displayed Carers need to be provided with opportunities for reflection, catharsis and space to calm their emotionally aroused state following contact with bereaved relatives Wright, B. (1988) Sudden death: intervention skills for the caring professions, London, Churchill.

Reflect on the last occasion when you supported distressed relatives What opportunities did you have to talk about the death(s)? How did you respond? Were you able to meet your own emotional needs afterwards?

Make a list of ten professional qualities that you possess

From this list identify your strengths when supporting distressed relatives

From this list identify the qualities that you feel you need to develop when supporting distressed relatives

Did your comments include? Non-judgemental attitude Caring human contact Sensitivity to their deep pain Warmth Compassion Competence Jones, and Buttery, M (1981) Sudden death: survivors’ perceptions of their emergency department experience. Journal of Emergency Nursing 7(1): 14-17

Dealing with the family promptly on arrival Tye, C. (1992) Qualified nurses’ perceptions of the needs of the suddenly bereaved family members in the accident and emergency department. Journal of Accident and Emergency Nursing, 18(6): 948-57 Most helpful: Dealing with the family promptly on arrival 2nd Providing a room for the family to use 22nd Providing comfort measures (tea) 23rd Allowing viewing of the body in the ED

Therapeutic use of ‘self’ Engaging - not being in a hurry Scott, T. (2007) Sudden traumatic death: caring for the bereaved, Trauma, 9: 103-109 Therapeutic use of ‘self’ Engaging - not being in a hurry Going that extra mile Offering words of comfort Therapeutic silence (being there) Delve deep into our own psyche Experiencing their pain Allowing words to emerge from silence

Iserson, K.V. (2000) The gravest words: sudden-death notifications and emergency care. Annals of Emergency Medicine, 36(1): 75-7 “Acknowledges the existence of a group of unfortunate people who, when they walk through the emergency department doors, are about to experience a defining moment in their lives due to the horror of what is about to be shared…”

“Unexpectedly they become our newest patients “Unexpectedly they become our newest patients. The question we must ask ourselves is, “Are we prepared for them?” (Iserson, 2000, p.75)

Thank you