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Pre-hospital protocol takes RTS practice beyond hospital walls

Since the beginning of the Resolve Through Sharing (RTS) program, collaborating with others—individuals and organizations—has been critical to the dissemination of RTS practice. Bereavement education programming designed for emergency responders is the latest result.

RTS pre-hospital bereavement protocol materials were developed in partnership with Gundersen Tri-State Ambulance of La Crosse, WI. Emergency personnel are provided with little to no bereavement training. This can cause them to feel helpless and unprepared when supporting survivors at the scenes of fatal incidents. During these times, the actions taken by emergency personnel can have lasting impacts—positive or negative—on survivors.

To address this issue, Tri-State and RTS established a protocol that provides responding personnel with bereavement education, tools to use in the field, and support materials to present to the bereaved. RTS and Tri-State committed to ensuring all components were appropriate to be used in any circumstance responders and survivors may experience. Some existing RTS materials and training were implemented with no adaptations (e.g., RTS online modules), some required minor modifications (e.g., support brochure used in the hospital setting), and some needed to be created to fill an existing gap (e.g., pre-hospital bereavement support checklist). When agreement was reached on all the protocol components, modules were distributed, and the tools for responders and support materials for the bereaved were designed.

RTS Pre-Hospital Bereavement Protocol includes the following:

Online Modules

Module content
  • Communicating With the Bereaved: This module covers what to say and what to do when caring for someone who is grieving, and strategies for communicating with the bereaved. Topics include understanding shock, delivering bad news, empathic communication, phrases that are not helpful, and more.
  • Memory-Making and Ritual: This module covers the importance of keepsakes, memorials, and ritual for the bereaved when one who is loved dies. The power of meaning-making can occur in moments. The smallest gesture can become part of a ritual, and the smallest token can become a priceless keepsake for years to come.
  • Guided Participation: A Method of Teaching and Learning: Learn what sets Guided Participation apart from other methods of teaching and learning, and how it supports relationship-based care and practice. As understanding of guided participation increases, interactions with others are transformed.

Pre-Hospital Bereavement Support Folder

Support folder

Tools for Responders

  • Bereavement Support Checklist: The checklist ensures that the protocol is met and care is standardized. As per the protocol, responders are asked to sign a sympathy card and fill out a page with contact information. Once the checklist is complete, it is retained for data collection.
  • Guided Participation Sample Scripts: These scripts are intended to guide responders in their conversations with the bereaved. Using guided participation, the scripts are written to empathically introduce the support materials.

Support Materials for the Bereaved

  • "With Deepest Sympathy" brochure: This brochure covers topics such as next steps, sharing the news with others, and honoring the one who has died. It also provides the bereaved with contact information of responding agencies.
  • "With Deepest Sympathy" card: Signed by the responding staff, this card may be an important memento for those grieving.
  • Letter template from responding agency: The letter explains the significance of the resources found in the folder and expresses sympathy on behalf of the agency.
  • "When Someone You Love Dies Unexpectedly" booklet: This booklet provides readers with caring insights, practical suggestions, and words from others who have unexpectedly lost a loved one. Topics include performing final acts of caregiving, facing unique issues, coming to terms, caring for self, caring for others, and making meaning.
  • "Understanding Grief" Brochure: This brochure discusses the different ways grief can affect individuals—physically, emotionally, socially, and spiritually. Topics include searching and yearning, understanding the journey, and hope.
  • "Resource Booklet:" Focused on general grief, this resource is easy to read and appropriate for many. Topics include common grief responses, complicated grief, coping with the holidays, and helping children through loss.

Not included in the folder but also available if needed is the booklet "Understanding Suicide: You Are Not Alone." It provides those grieving a death by suicide with information on understanding suicide, including language, stigma, possible factors and conditions, and challenges survivors face.

To learn more, read "Gundersen Tri-State Ambulance in Wisconsin Offers Bereavement Support Tools for EMS" in the Journal of Emergency Medical Services (JEMS).

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