Preparedness of emergency care providers to deal with death, dying and bereavement in the prehospital setting

Abstract

Introduction: Emergency care providers are exposed to events involving suffering and tragedy as part of their routine work in the field. They are accordingly expected to deal with death, dying and bereavement in a safe, sensitive, efficient manner, showing empathy and compassion while managing their own emotions. This can be stressful and lead to trauma symptoms, anxiety and depression. Purpose: To investigate how prepared emergency care providers are to deal with death, dying and bereavement in the prehospital setting in order to recommend strategies that will diminish the emotional strain they experience, as well as decrease the trauma of sudden death and the number of abnormal grief reactions for the bereft. Methods: The study used a quantitative descriptive prospective design. Data was collected using an online self-report questionnaire that was sent to all operational emergency care providers in the Dubai Corporation of Ambulance Services (DCAS). The data from consenting participants (n = 496) was analysed using the IBM Statistical Package for Social Sciences (SPSS) version 25.0. Inferential statistical techniques such as correlations and chi-square test values were used and interpreted using the p-values. Factor analysis was also conducted for the purpose of data reduction. Results: The majority of respondents (n = 316; 64.4%) reported that they had not received any formal education or training on death, dying and bereavement. Those that had received formal education or training reported that this training was conducted mainly by nursing (n = 124; 25.9%) and paramedic (n = 65; 13.6%) instructors. A quarter of the respondents (n = 126; 25.4%) reported experiencing intrusive symptoms such as loss of sleep, missing work and nightmares as a result of a work-related death or dying incident, but only a few (n = 20; 4.1%) had received professional counselling. Conclusion: This study found that emergency care providers are underprepared to deal with death, dying and bereavement and reported discomfort and anxiety associated with this aspect of their job. A comprehensive death education programme that encompasses the diversity of death and the unique challenges that the emergency and prehospital setting presents should be implemented to reduce emotional anxiety, help emergency care providers cope better with death and decrease the number of abnormal grief reactions on the part of the bereft.