You just finished working a field termination in front of the family, now what? It’s a moment that lingers in the memory of every emergency responder—the first time you had to deliver the devastating news of a loved one’s passing to the family.
The experience is often seared into our minds, yet it remains a topic that is rarely discussed. Despite its emotional weight, this crucial aspect of our profession is often left unaddressed. So, let’s start the conversation.
The Absence of "Death Talk" in Emergency Services Training
In all the hours of firefighter/paramedic training we received, there was never discussion on how to tell a family member that their loved one has died. The topic was never mentioned.
Having been in emergency services for over twenty years, I have had that discussion hundreds of times. It’s never easy to do. Telling someone that their loved one is gone and not coming back is crushing, and I dread having to do it.
From the outside looking in, we don’t prioritize equipping our members and students with the necessary skills to handle such situations. By neglecting this critical topic we leave our members to fend for themselves. We are failing in our leadership and educational responsibilities by doing this.
It’s time to move away from the “no one told me” mentality and take an active approach to address our training gaps and shortcomings. Allowing public safety personnel to fail due to our past oversights is not a workable answer. Let’s learn from our failures and tackle this issue constructively.
The "Death Talk" Checklist: Keeping It Short and Specific
As a preceptor and training officer for our department, one of the “check-offs” that happens is the “death talk”. When we do a death talk training, we utilize a training aid already out there instead of creating our own (Hobgood et al., 2013). The acronym we use in training on how to deliver this bad news is GRIEV_ING.
G- Gather the family or other members present.
R – Seek out resources to help with grief, such as religious, family, and friends.
I – Identify yourself and name the deceased by name.
E – Educate the family or friends to the brief events and information that you do know.
V – Be clear and verify that the patient has died or is dead.
(_) – Space is just that, giving a moment to let the news set in.
I – Inquire or ask if there are any questions.
N – Nuts and bolts… offer the members to say goodbye to the body.
G – Give them contact information or resources to assist.
Using this guide, I explain to the member that you need to keep it short and to the point. Do not say things like “they have passed” because that can lead to questions like “passed where” or “have gone where?” This is not the time to have larger philosophical debates. Nor do we know what religious beliefs people have. So, saying that the person has gone to Heaven is also inappropriate. We can’t make assumptions about religion or belief.
I suggest employing the method of saying, “I’m sorry for your loss, (name of person) has died.” If they have further questions about how, again, answer with specifics to what you did. Remember you are not the coroner or medical examiner; you cannot say exactly what happened or how the person did die. Don’t make assumptions. You can help in a reassuring way , “Is there any family or friends you can call to inform and who can assist you through this time?
Often with our field termination or other death calls, we have police officers on the scene who step in and take over a lot of the death notifications. They do a great job working with the family and tend to stay on the scene longer for their report.
How a Walkthrough Scenario Can Transition to Real Life
Our “death talk” training includes a walkthrough scenario. Role-playing the situation allows you to get used to saying those most difficult words. You should continue this training frequently. You should discuss what can happen on the scene and what to expect. Talk through the entire scenario until that first real call happens.
Even with purposeful training, this task is still going to be challenging. Here is a real life experience I had with a trainee:
A few years back I was precepting a young new probie named Dallas. One morning we were called for a welfare check and arrived at a home to find that an elderly woman had died. She had been dead a while and was obviously gone for at least a full day. There was no need for any paramedics. The neighbor had come over to check on her because the daughter had not heard from her mother in a few days. Police officers were also on the scene with us. I was speaking to the police officer, and we were getting basic information on the deceased woman when we heard the house phone ring and young Dallas behind us talking. As we turned around, we heard him say, “I need to inform you that your mom has died.” Both our mouths dropped as we realized he must be talking to the daughter. “Yep, she’s dead,” he said and then hung up. We looked back at each other, and I said, “Who was that?” “The daughter,” he said. “She was pretty upset. I could hardly understand what she was saying with all her crying.” The police officer then used his cellphone to call the daughter back and Dallas and I walked back out to our ambulance. (Two Dark Thirty reference Ch. 9)
Every instructor has this moment, that is not what we practiced! I asked him what was that all about? He told me that I told him to “just be honest”. I smiled to myself and told him, yes but you need to also have some compassion in your voice and set a tone.
The Importance of Compassion and Tone
This trainee’s situational incident was interesting at the time because he was so blunt and brutally honest. He was right that I told him to be honest. But the frankness and the tone also come into play. Think about how your message will be received and what tone of voice you use to relay it.
In these types of situations, a gentle touch is needed with a whole lot of compassion. Roleplay these types of scenes, practicing empathy, compassion, and tone of voice with your students and probies. Make an effort to roleplay and act as it will be in real life. Go through the best-case and worst-case scenarios. Give them the tools, such as additional resources from multiple views, to build upon their knowledge. Here are some more tools you can use to assist in this process:
From “Breaking Bad News: A Guide for Health Professionals“ by Robert Buckman:
- “Effective communication skills are the key to breaking bad news successfully.” (p. 3)
- “The process of breaking bad news should be gradual, supportive, and conducted in an unhurried and relaxed atmosphere.” (p. 24)
- “Breaking bad news to patients is not something to be done alone.” (p. 80)
- “It’s essential to establish trust and rapport before delivering bad news.” (p. 32)
- “Choose your words carefully and avoid technical jargon or euphemisms that might be confusing or misunderstood.” (p. 68)
- “Acknowledge the recipient’s emotions and demonstrate empathy by actively listening and responding to their needs.” (p. 84)
Let’s stop ignoring the difficult conversation of telling a family member that their loved one has died. For many, this conversation may be the worst of their lives, and they will remember these conversations forever. Let’s set first responders up for success.
Firefighters and paramedics are often the first people to arrive on the scene of a medical emergency, which means they may be the ones tasked with breaking the news to the family members. It’s important for these emergency responders to be prepared for this conversation. It may provide some closure for the family, and it can help the first responders process their own emotions and experiences.
When firefighters and paramedics are trained and equipped to handle these types of situations, they can provide better care to their patients and their families, which ultimately strengthens the community.
Here’s a list of resources that may be helpful for readers:
- Mental Health in the Fire Service: Are We Failing?
- The benefits and challenges of being a firefighter: What you need to know before pursuing a career.
Additionally, readers may also be interested in training programs, such as those offered by the Center for Loss and Life Transition or the Grief Recovery Method. These programs can provide more in-depth education and support for those who need to deliver bad news in a compassionate way.
References and Citations
Buckman, R. (2013). Breaking Bad News: A Guide for Health Professionals. Johns Hopkins University Press.
Hadden, A. (2017). Delivering Bad News in Good Ways: Turn Difficult Conversations into Purposeful Dialogue, Positive Outcomes, & Stronger Relationships. Berrett-Koehler Publishers.
Hill, M. (2022). Two Dark Thirty: True stories to inspire teaching and learning in our local heroes. Smoky Coast Press.
Hobgood C, Mathew D, Woodyard DJ, et al. 2013: 17 Death in the field: Teaching paramedics to deliver effective death notifications using the educational intervention ‘GRIEV_ING.’. (4), Prehosp Emerg Care, pp. 201-510.