How many jobs let you into so many people’s lives? Right through the front door, sometimes with only a cursory knock, smack bang into the middle of their most vulnerable moments. Strangers in green, stomping our boots around their home, it can be intimidating, even frightening, or possibly a welcome relief. That said, it’s usually with a smile on our faces, and seeking to put minds at ease and reassure families. Sometimes however, maybe from the information already provided to us en route, but mostly from our rapid initial assessment of the scene and patient(s), we aren’t so cheery and may seem like we are firing questions at family/bystanders. Time, we have concluded, is of the essence, and we’re not in a position to exchange pleasantries (although we always remain calm and professional, of course). It’s nothing personal, but a hospital environment and lots of helping hands are luxuries we do not possess.
Let’s face it, if we’ve been called, then they’re not going to be at their best. The most happy occasion we’ll be called to is a childbirth. I think I can speak for all mothers in saying that’s definitely not a time when you are at your best, despite the wondrous event! I’m sure I’m also not alone in admitting it’s actually not one of our favourite jobs. Midwives we are not. There are so many variables and so much opportunity for complications. Not to mention the fact that we are dealing with two patients. Our initial assessment is based on whether we think we have time to get to hospital, because if we don’t think so, then we’re staying put. I’m sure no woman fancies giving birth in an ambulance on the hard shoulder of the motorway! Straightforward, uncomplicated births are an amazing experience and result in smiles all round, even if they are mainly plastered on our faces to hide the enormous relief we are feeling. Still, it’s good to have an element of the job that has such a happy ending. Being part of bringing someone into the world is extraordinary, even if our main role is to be good at catching!
What we tend to encounter far more often unfortunately, is someone leaving this world, and the variables are even more extensive. Young, middle-aged, old, sudden, expected, medical, traumatic, suicide, murder, location….to name but a few. If you’d told me 20 years ago how many dead bodies I’d get to see in my lifetime, I’d never have believed you (and would probably have been mildly disturbed). Have I become immune to the sight of a lifeless person? Sometimes I think so, especially when I have to tell someone that their obviously dead loved one has actually died. I mean, how could they not tell? Is it really my experience? Or is it just their denial? They knew, but couldn’t bring themselves to believe it until someone ‘official’ told them maybe? Or were they actually hoping we could resuscitate them despite them being dead for 20 minutes (without ongoing effective CPR), 20 hours or even 20 days? (And yes, that last one has happened to me.) Perhaps I just need to remind myself that that might be the first dead body they have ever seen…..and that I haven’t seen everything yet.
The one thing I will never get used to when dealing with the families is telling them the worst news they could imagine. Don’t remember that one in the job description, or in my training for that matter! Reactions have ranged from blank stares to collapse, from sobs to hysterics, and endless pleas for us to do something more. Each one leaving me think I must have done it wrong, but exactly what is the right way? Obviously with sympathy and compassion but it must be clearly and concisely. There’s no room for confusion with this situation. You must simply tell them that their father, mother, husband, wife, son or daughter is dead. Not ‘he’s gone’ or ‘she’s passed’. That, apart from being an avoidance tactic, can be misleading or create false hope in times of stress and denial. We may mean well and want to ‘break it to them gently’ but we must also be direct.
Their eyes scanning yours as you enter the room, pleading with you to bring some hope, you can see them holding their breath, wringing their hands. You’ve been in that room, working on him for a while now. You’re exhausted, sweaty and slightly dishevelled. All that effort, they’re thinking, surely it must be good news….