One of the hardest jobs in the fire service in general, and emergency medical services in particular, is notifying next of kin that a death has occurred. Whether a person dies in a fire, an industrial mishap, an auto accident or from natural causes, those on the scene often have to help survivors deal with the situation.
"Firefighters receive a lot of training in the technical and physical aspects of the job," said Dr. James Hendricks, a criminal justice professor at Ball State University in Muncie, IN. "Unfortunately, there is often not much attention paid to death notification. They never know when they may be called upon to deliver a death notice and it needs to be done properly."
One stumbling block can be the responder's own feelings about death. American society tries to ignore death, few people can discuss it comfortably and little systematic help is given to survivors. Phrases such as "passed on" are used to avoid using the term "death." Even those in the public safety professions are not immune as shown by making grim jokes in an attempt to minimize their natural feelings.
"A person can get dragged down into unproductive interactions unless they have first resolved many of the issues surrounding death within themselves," stressed Hendricks, a past president of the National Academy of Crisis Intervenors. "If they haven't adequately resolved a death in their own family or even thought about their own death, it will inhibit them from helping others through the grieving process."
Death notification under the circumstances often seen in the fire service can be very difficult. The scene of a fire is often too loud and busy and lacks privacy. If at all possible, the responder should find a private place to talk to survivors. Another problem is that those at the scene dealing with the survivors may not know exactly what has happened. If the victim has been transported to a hospital, the firefighter should tell the family members which hospital the person was taken to and then help them arrange transportation.
Even if a death is confirmed, the people at the scene may not be able to answer all of the family's questions. Problems with positive identification of the victim or delay in establishing cause of death may leave the firefighter with uncomfortable feelings.
Given these problems, the firefighter must be very careful about what is revealed at the scene. If the body has not yet been identified, the best course is usually to tell the family only that which can be confirmed and explain carefully why more information is not yet available. Make sure they are told how to get the details needed.
When the actual notification is to be given, it should only include family members with clergy available, should they need them. It is generally best to tell them you have some bad news and let them have a few seconds to comprehend that. Then, tell them you have serious news. The third stage is the actual notification of the person's death.
"When someone asks you a direct question, not only are they as ready as they will ever be psychologically to receive the news but to tell them anything else would be unfair," Hendricks noted. "Otherwise, you open the possibility that their loved one is still alive only to devastate them a few seconds later."
After the news is broken, the survivors often ask about the cause of death. This can be a tricky situation for the responder. Even with a body charred in a fire, it is possible that a homicide or suicide took place. In these cases, tell them you don't know yet. Again, let them know who they can contact to get these questions answered.
Don't hesitate to give the family any information you have that is not confidential. Often survivors will lead the conversation by asking questions. This allows them to get the information they feel is important at a rate they can comprehend. As much as possible, keep the conversation directed toward the survivors and their needs.
"This is a very traumatic time emotionally," Hendricks said. "They will have a lot of questions that are unanswerable. It is best not to respond to these in either an affirmative or negative manner. Console them and help them redirect their energies to the tasks at hand."
The firefighter should be alert to typical and atypical reactions to grief. Typically, the person will show feelings of guilt, anger, isolation, crying and a sense of loss. If they state they don't want to live without the victim, that they have plans for hurting themselves or that they are to blame for the death, an atypical reaction may be starting. Under no circumstances should this person be left alone as the possibility of harming themselves or committing suicide is very high. Someone needs to stay with the survivor until another family member, friend, clergy member or other responsible party arrives.
When all information that is available has been provided, end the notification tactfully. Ask the family members again if anything can be done to help the family and offer them assistance in getting in touch with friends, neighbors and other family members. The mental status of the loved one should be assessed one last time, looking for indications of an atypical reaction. Finally, reconfirm that someone is enroute to stay with them.
"A person needs to be compassionate, understanding and genuine," Hendricks said. "It's impressive to the survivors when this tough situation is handled correctly. They feel that someone cared about them and helped them through a very difficult time in their lives."
Kurt Ullman, a Firehouse® contributing editor, is a registered nurse and regional chairman of the volunteer Indiana Arson and Crime Association.
