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  • Preparing for death and tragedy

  • Lexie Hein
    Chief Scribe

    A patient codes or is given a terminal diagnosis in the office, are you and your scribes capable of dealing with these events? I am writing this post due to a failure on my part to realize others without a similar background as mine may not have the ability or knowledge to properly deal with death or tragedy properly. Some of our clinics deal with terminal diagnosis, have emotional patients and families, or hospital settings where death may occur.

    I think primarily we need to prepare our scribes for these events to happen. As managers, we not only need to prepare our team, but also follow up in cases when our scribes or fellow managers are struggling with a particular patient or situation. It is also our duty to proactively prepare our scribes in order to deter any poor reactions from occurring.

    Here are some ways to prepare your scribes and support them when they experience an emotional case.

    -First, know that everyone deals with emotions differently, and there is no wrong way to grieve. However, there is a wrong way to react in front of the patient and family. During classroom training, please speak about potential things that can occur on their shifts. Teach them how to properly respond in the room to these events (keep calm, busy yourself with other tasks on the computer, get tissues for the patient or family, and leave the emotional support to the family to the doctor).

    -Reflect about their emotions and write them down. Writing and seeing the words can help the healing process.

    -Organized discussion and reflective writing, to help scribes identify and cope with their feelings about death and dying.  If you are aware that more tragic cases seem to be rolling through your ED, it might be time to have a check in with your team to make sure everyone is handling these events. If necessary, add discussion to All Scribes Meetings or a special meeting to address coping and concerns. Some people are more willing to speak in a group, while others are going to need a private environment. Start with the group and offer your time for any follow up.

    -It is important to know that over time and exposure, you will gain ways and mechanisms to cope in your own way.

    I have put together a brief statement you can send out to your teams or new scribes in clinics, ED, or Hospitalist positions that could experience some pretty tragic things.

    “Emotional things happen in the hospital or clinic. People die tragically and unexpectedly or a terminal diagnosis is given. In some cases, family members are present reacting to the news. You are not immune to feeling sad when something tragic occurs. Your reaction and feelings to the death of a patient may shock you. It is important to realize feeling sad is normal.

    As a scribe, you should be aware that some situations will get to you. No matter how prepared or “strong” you feel, some situations will stick with you more than others. Whatever the reason, it is helpful to understand some situations will cause you to get a bit emotional. While you are dealing with family members or other staff, try your best to hold it together. But afterwards, give yourself time when you are alone to work through your emotions. Holding these thoughts and feelings in may be damaging to your psyche or your successful future in the medical field.

    I would like to offer my full support and a completely open door to discuss any concerns you may have. I have experience with dealing with these matters and would be more than willing to listen and help guide you though these feelings.”

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