Abstract
BackgroundThe emotional consequences of patient deaths on physicians have been studied in a variety of medical settings. Reactions to patient death include distress, guilt, and grief. Comparatively, there are few studies on the effects of patient death on physicians and residents in the Emergency Department (ED). The ED setting is considered unique for having more sudden deaths that likely include the young and previously healthy and expectations for the clinician to return to a dynamic work environment. To date, no studies have looked at the effects of patient deaths on the more vulnerable population of medical students in the ED. This study examined aspects of patient deaths in the ED that most strongly influence students’ reactions while comparing it to those of an inpatient setting.MethodsSemi-structured qualitative interviews were carried out with a total of 16 medical students from the American University of Beirut, Medical Center in Lebanon who had recently encountered a patient death in the ED. Questions included their reaction to the death, interaction with patients and their family members, the response of the medical team, and coping mechanisms adopted.ResultsThe analysis revealed the following as determinant factors of student reaction to patient death: context of death; including age of patient, expectation of death, first death experience, relating patient death to personal deaths, and extent of interaction with patient and family members. Importantly, deaths in an inpatient setting were judged as more impactful than ED deaths. ED deaths, however, were especially powerful when a trauma case was deemed physically disturbing and cases in which family reactions were emotionally moving.ConclusionThe study demonstrates that students’ emotional reactions differ as a function of the setting (surprise and shock in the ED versus sadness and grief in an inpatient setting). Debriefing and counseling sessions on ED deaths may benefit from this distinction.
Highlights
The emotional consequences of patient deaths on physicians have been studied in a variety of medical settings
Themes are discussed in relation to both the Emergency Department (ED) and the inpatient setting
The patient illnesses encountered in the ED and inpatient setting are presented in a table (Table 1)
Summary
The emotional consequences of patient deaths on physicians have been studied in a variety of medical settings. This study examined aspects of patient deaths in the ED that most strongly influence students’ reactions while comparing it to those of an inpatient setting. Medical professionals dedicate their lives to the treatment of patients in an attempt to cure, all the while knowing that any cure is temporary. Physicians in the emergency department Studies addressing the effects of death on physicians in the emergency department (ED) are minimal It is recognized, that the ED is a unique setting: Batley et al BMC Medical Education (2017) 17:110 there is generally no previously established relationship between the patient and the physician, deaths are likely to be sudden, and could include the young and previously healthy. Deaths that are characterized as shocking and unexpected are known to lead to more distress and psychological trauma than natural and expected deaths [7]
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