Oct. 05, 2019
Facing a bleak job market in a depressed economy upon graduation from Winona State University in 2010, Austin Melville continued with his job at a local supermarket while seeking work in his chosen field. Despite the job situation, Austin was looking forward to a winter internship and an upcoming wedding date with his girlfriend.
Late one evening six months after graduation, while out with friends in downtown Rochester, Minnesota, a car operated by an intoxicated driver struck Austin as he walked across the street. Sandy, Austin's mom, was surprised when the phone rang a little after midnight, as Austin was planning on staying with a friend. Now, instead, that friend was calling Sandy and screaming that something had happened. All Sandy could hear were sirens in the background.
Sandy and her husband, Hilary, hurried to the emergency department at Mayo Clinic Hospital — Rochester, Saint Marys Campus, and starting asking registration staff for information on their son. As Austin had just arrived by ambulance, no information was available and they were escorted to a private family room, close to the resuscitation area. The couple had been in this room before when Sandy's grandma died, so she felt uneasy and prayed for minor injuries.
About 45 minutes passed before they got an update. A physician arrived and said, "We are very, very sorry. We were unable to revive him."
Austin's parents were in shock. "When you hear the news that we got, there are really no words," Sandy said. "At that moment, it is like an out-of-body experience: This couldn't be happening. You can't grasp it. Your brain can't process, especially when you have a son who's always been cautious and made good choices."
Various members of the emergency department staff talked with the Melvilles for a while, yet Sandy recalls the conversation was almost a blur in her grief and confusion. She remembers making a call to her daughter and asking her to come to the hospital.
Nurses then took Sandy and Hilary to see Austin. Sandy recalls wandering through the department like a zombie and then arriving at a small, private room where Austin lay covered up from his toes to his chin. "It looked like he was sleeping," Sandy said. "He had no visible signs of trauma. I remember thinking, 'He can't be dead.'" The emergency department staff stayed with the Melvilles while they spent this private time with their son.
Reflecting on her personal experience, Sandy is able to offer suggestions to medical staff working with bereaved families in the future:
Provide contact, communication and context along the way
Sandy recalls feeling frustrated knowing that Austin had died, but she did not know how or why. She encourages staff to check in frequently with families awaiting news on a loved one, providing any available information — any little piece of data can help. She stresses that surviving family members often feel isolated, so having a support person available is also helpful, if possible.
Sandy goes on to suggest that the following details might offer a bereaved family peace of mind that everything has been done for their loved one:
- What injuries did he sustain?
- Was he breathing when he arrived at the hospital?
- What measures did the staff take to revive him?
- Were there other interventions done, such as X-rays?
Be cautious when discussing organ donation
Thirty minutes after arriving home from the hospital, a nurse called the Melvilles asking about possible donation, in this case tissue and eye donation. Sandy was surprised by the call, because Austin had not indicated interest in being a donor on his driver's license. She recalls feeling distressed at being asked such questions so shortly after learning he had died and viewing his body. While medical staff was doing what is required by law, Sandy wants all to be aware of how this topic might affect those on the receiving end of these questions.
Since the time of Austin's death, specialists from Mayo Clinic's Office of Decedent Affairs now report to the hospital for every death to help families with next steps. During this discussion, the family is prepared to receive a phone call about organ donation, so the surprise is not so distressing at a time of intense grief.
Prepare to offer families mementos
When Sandy saw Austin's body at the hospital, she suddenly wanted any possible physical remembrance of her son as important tokens of his life. She asked the nurses for a scissors to cut a lock of his hair.
Sandy wants all providers to recognize the strong desire a recently bereaved family member might have for any keepsake of the deceased. She suggests all hospitals have a mechanism to help meet this need for families. If your hospital currently doesn't have a way to provide mementos to families, reach out to tertiary care facilities you work with and learn about options available.
Utilize experienced staff, if possible
Sandy notes she is aware that informing a deceased patient's family like hers with Austin's death is challenging for medical staff and that dealing with grieving families can be uncomfortable for all involved. For instance, she says she felt bad for the nurses who took the Melvilles to view Austin's body.
Under ideal circumstances, utilizing medical staff with some experience in these types of situations might enhance an already difficult process. All emergency providers are expected to deal with bereaved families, so hospitals might consider some simulated training opportunities, as well.
Sandy also notes that choosing words carefully when dealing with grieving parents is important, indicating that sometimes silence is best. Staff can help by listening and giving a grieving family something to lean against when their world seems to be collapsing.
Know the hurt won't go completely away
Grieving the loss of a child is not an activity that fits into a defined time frame, according to Sandy. Aware that emergency providers can be at a disadvantage not knowing what goes on once a bereaved family leaves the emergency department, Sandy wants them to be aware that the grief process is a long-term journey.
"The journey is for life," she said. Everybody's under the assumption I'm healed, but it doesn't go away."
For more information
Office of Decedent Affairs. Mayo Clinic.