From rescue worker to grief counselor
Even after the words tumble out, the tension on those 911 calls can linger. What else should be said? How much time will pass before a police officer or the coroner arrives? A county policy shift this year could have emergency crews spending more time trying to resuscitate patients in the field, as opposed to interrupting rescue operations and rushing people to local hospitals. In those cases, doctors and medical workers usually take over, and it becomes the hospital’s job to break the news that a patient has died. The Redondo Beach Fire Department recently held classes for firefighter-paramedics and others in Hermosa Beach to help ease the sudden transition from rescue worker to grief counselor. Some tips were as simple as making eye contact, avoiding arm-crossing and allowing the silence – no matter how awkward – to simply take over. “If you just sit with them, be with them. You don’t really have to say anything,” said Glen Komatsu, a Little Company of Mary Hospital-Torrance physician specializing in palliative care, which aims to relieve physical and emotional suffering. “Sometimes words are just inadequate,” Komatsu said. “Hand them some Kleenex. Let them sob. Human presence is very powerful.” Several firefighters and paramedics who gathered for a recent counseling session agreed. Still, it can be easier to stay busy packing up equipment and clearing the scene rather than struggle for the right thing to say, some of them explained. “Detachment has been the preferred method of dealing with those types of situations,” one rescue worker told Komatsu. Greg Allen, who heads the Redondo Beach Firefighters Association, said the department arranged for grief counseling classes so it can better assist local families, which he calls “extended patients.” “We’re not going to leave them there to take care of everything,” Allen said. The classes follow a policy change from the Los Angeles County Emergency Medical Service Agency, which oversees the county’s 911 system. Following American Heart Association guidelines, the agency now suggests emergency crews remain on scene with cardiac arrest patients until there’s a return of spontaneous circulation – meaning the patient shows signs of a palpable pulse – rather than interrupting the process to transport a person to the hospital. William Koenig, the agency’s medical director, said the shift made in February reflects the view that patients can be better served if paramedics are dispensing medication and continuing chest compressions on scene while consulting with hospital workers by phone. And if it’s clear to paramedics that a patient has died at the scene, a high-speed ambulance ride could needlessly put other people at risk and create false hope for a family, he explained. Although the consulting physician would likely pronounce the patient dead, firefighters and paramedics are left to face grieving relatives. It’s something they already know how to do and have received training for, Koenig said. But those kinds of conversations could happen more frequently. “I do think quite frankly that the classes are beneficial,” said Koenig, director of emergency medicine at Long Beach Memorial Medical Center. “I think education is really important.” Redondo Beach held three counseling classes last month in the main library and will likely train future recruits, said Allen, the association’s president. The sessions brought together a physician, a hospital chaplain, a grief counselor and a mortuary director, all offering different suggestions. Their information will be included in a pamphlet the city will stock in its firetrucks and ambulances – lists of local funeral homes, mortuaries, counseling services and more. Redondo Beach Fire Capt. Scott Harper, who attended a class with his colleagues, said he welcomed the input. “We basically stand by, and there’s not a lot to do. ? Some guys were uncomfortable dealing with family members who were going to be emotionally upset,” he said. “What can we do to soften that blow?” But the advice wasn’t all for the families. Darrah Glynn, who works as a chaplain at Little Company of Mary Hospital-Torrance, said it’s unrealistic for emergency workers to respond to a trauma and simply move on. “It’s going to affect you. You’re going to have a patient pass away that’s just like your grandfather, just like your niece,” she said. “Find a good support group for yourself.” [email protected] local news?Sign up for the Localist and stay informed Something went wrong. Please try again.subscribeCongratulations! You’re all set! REDONDO BEACH: Emergency firefighter-paramedic teams are being trained to help families cope when a patient dies at the scene of a 911 call. By Kristin S. Agostoni STAFF WRITER The minutes can feel like hours during those sad, awkward times when firefighters and paramedics have to report a patient’s death to a worried family.