He talked with her and figured out she was frail and alone. He called her neighbor and me and made sure someone was with her before telling her of my brother's almost certain death. A private room in which to break the news and letting the family remain there is important, as is allowing them time with the body if they wish. Several respondents expressed gratitude at being able to see the patients as soon as they left the ER, whether or not they were presentable, if the prognosis looked bad. At first there was concern that the family would be disruptive, or that we needed to protect them from the patient's appearance, but they're usually so overwhelmed they prefer to go back to the waiting room and appreciate the opportunity to see the reality of what's happened.
People often feel cheated if they miss seeing someone during their last minutes of life.
Other recommendations, now in effect at Harborview, included assigning a nurse to the family through the admission and death process to help facilitate the flow of information. Social workers and chaplains are also present whenever available. Although most responses from the survey were positive, a few physicians were found to be insensitive. There is increasing recognition that medical training needs to be extended beyond the science of illness and into the art of caregiving. He plans to extend the project to study the effect of stress on resident physicians, and results will be incorporated into a teaching program.