Crisis Intervention & Response LESSON #9 — Dealing with Death – Hospital Protocol

Responding to a crisis call which involves a patient being transported to or already at a hospital is most difficult. There are so many variables that dictate what steps are to be taken initially.

Timing dictates the crisis responders first reactions to a situation when a patient becomes involved with a hospital. If flexibility is a byword of crisis response, a call involving a patient in or being transported to the hospital is the hallmark.

Responding to Home or Office

In most cases if the patient is not yet in the actual process of being transported, establish the details of the situation.

  1. If it would be appropriate for one member of the family to accompany the patient in the response vehicle, make arrangements with the first responders. There will be others who wish to go immediately. If transport in the responding vehicle is not practical, establish someone present who appears, for the moment, to be calm and seems strong as a designated driver and ask them if they can to provide transportation to and from the hospital. If no one is able to be a driver, offer to transport the immediate family in your vehicle, insurance permitting. In all cases discourage the immediate family members from driving their personal vehicles. Their mind will not be in a right place to be driving.

Responding To An Accident Scene

If responding to a scene of an accident or incident outside of a home or office setting then the priority is to notify next of kin and/or proceed directly to the hospital if the relatives have been notified.

  1. Establish who will be responsible to notify family members of the situation. If the crisis responder is charged with the notification simply explain, in person if possible, that the individual is being transported to XYZ Hospital. Explain that you do not have any details at this point. Even if you know details it is not the time or the place to disclose the condition of their loved one.
  2. If the relatives have already been notified or are about to be, proceed directly to the hospital.

Hospital Protocol

Upon arriving at the hospital take charge of the family members and explain that they gather and wait in the waiting area and you will find out the details of the situation. You then need to check in with the desk or duty nurse and explain that you have family members of the individual just admitted.

Many hospitals will have what is called a “quiet room” in which you can take the family. Anticipate that the word will spread quickly and additional friends and family will appear almost immediately. Each time someone new appears demands will be made to know what is going on and the desire to go to the patient will be insisted upon. Explain to each why that is not possible.

Generally, the ER staff will be working the patient and that is exactly what you convey to the family indicating that there is too much activity for them to be in the area with the loved one. All hospitals will have rules and protocols. Pay attention to the nurse’s instructions and use them in dealing with the family, reformatting or restating them in tactful ways.

The waiting and not knowing is the main stressor on the family. As much as practical leave the waiting area and check on the patient’s status. If you are told that it doesn’t look good, report back to the family and ONLY indicate that their family member is very critical and they are doing the best for him or her. If the patient has died, do not disclose that. It is up to the doctor to initially speak with the family.

After the doctor has broken the worst news, ask if family members wish to say their goodbyes. If so, tell them that it will be just a moment to get the equipment out of the way. Inform the hospital staff of the family’s desire so they can prepare the body. Sometimes the staff will move the body to a less active area where the emotional scene that is about to unfold will not be as disturbing to the other patients. Generally, the deceased will be in the treatment room.

Depending upon the ERs activity, it will be the crisis responder’s responsibility to, after a respectful but not lengthy period of time, suggest that the family regroup with the other friends and family back at the house. Again, recruit the help of the less emotional (for the moment) individual in the group to shepherd the family back to their home where details can be finalized.

For more information concerning the process of Crisis Response Management, watch for Lesson #10 – Dealing With A Working Fire

Pete Adams
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