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Editor’s Note: This is part 1 in a two-part series by Daniel J. McGuire, a board-certified grief educator and counselor who works with emergency response agencies to prepare for losses within their organizations. Part 2 will appear in the Fall issue of Vertical 911.
Mayday, mayday! can be the most disturbing words ever transmitted to communications in any helicopter emergency medical services (HEMS) or other public safety aircraft operation.
With it comes the realization that when a medical, law enforcement, or search-and-rescue aircraft crashes, there is a potential death toll of two or more crewmembers and quite possibly the patient — serious losses that can be difficult to comprehend in the state of raw, unfiltered shock that sets in after an accident occurs. This is not to mention the loss of resources and the resulting limitations placed on saving the lives of other patients who are seriously injured or ill.
In 20 years of facilitating discussions with emergency response agencies, the questions I’ve been asked most frequently with respect to line of duty deaths (LODDs) are, “Where do we begin?” and “How do we begin?” Before getting into the specifics, I often share three guidelines that should be used to shape any standard operating guidelines or procedures: tradition, honor, and respect. Keep these values in mind as you work to create a program worthy of your valued colleagues who might end up making the ultimate sacrifice.
A LODD or serious injury is a tragic and very difficult event for any emergency response agency to get through correctly. Any organization involved in a LODD event will experience disturbance of normal operations; raw emotions; intense feelings of grief, sadness, anger, and bereavement; and will face very difficult days and weeks ahead. These factors necessitate pre-planning and awareness of the fact that no single person will be able to handle the immense number of responsibilities and action points associated with a LODD.
If you have any title or rank before or after your name (e.g. director, captain, CEO, or president), your employees will be looking towards you immediately as the person who will know how to handle this sudden tragic loss. Are you equipped to manage such an awful event, while also balancing the need to maintain minimum daily operations and keep the lights on? When a LODD event occurs, your agency cannot “shoot from the hip” and expect to accomplish these minimal tasks while also adequately supporting the surviving family and colleagues. To prepare for such an occasion, you need to adopt the mindset that it’s not if this will happen to your organization, but when.
Two ‘families’ to consider
When we work (and live) in a collective unit like a HEMS program or other emergency response agency, we build lasting relationships characterized by deep trust in one another. Consequently, we end up with two “families” that we deal with on a daily basis: a strong work family, and the biological family we go home to after our shift is over. It is not uncommon for many of us to spend more time with our work family than with our loved ones at home.
I bring this up due to the fact that in the wake of a LODD, it can often happen that the surviving agency — the “dual family” — can begin to overtake the surviving family when it comes to funeral planning and related items. This is generally not done from any sense of malice or disrespect, but as a consequence of the surviving agency’s complicated grief. In such situations, our EMS training encourages and enhances the ability to take over in a way that can push the surviving family off to the side — mistakenly so.
For this reason, in the event of a LODD, the surviving agency’s leadership must make a concentrated effort to work in concert with the surviving family, remaining in an assistance position without crossing over into a decision-making role. With this said, one tool that I strongly encourage your agency to adopt is some type of emergency contact form (ECF) for all of your field personnel. This form should have a minimum of two emergency contacts who you can reach out to before the details of a tragic event break on social media.
In addition to these names and contact details, part A of the ECF should include such important details as:
- The employee’s personal data (complete name, date of birth, address, and phone numbers).
- Whether the employee has any siblings in the immediate area.
- Whether the employee is an organ donor (this is often overlooked or unknown by surviving family members).
- Is there anyone at the home address who has a fragile condition that could be exacerbated by a death notification? Is there anyone who has a hearing or speech impairment?
- Are there any younger children at the home address? (If so, an extra person may be needed to occupy the children while you work with the surviving spouse.)
The ECF should also have a part B that will help your agency and the surviving family arrange funeral services in accordance with the deceased employee’s wishes. It often happens that the surviving family’s deep, sudden shock may compromise their ability to make quick decisions and deal with the tasks facing them. In such cases, having the employee’s stated desires readily available can be of help to the family, provided you respect their primacy as decision makers. It is important to note that not only your employees, but also their spouses or close family members should be involved in answering questions such as:
- What type of funeral and/or wake services do you desire?
- Do you wish to be buried, and if so, would you like to be
buried in your flight suit or other agency garment?
- Would you prefer to be cremated? If so, what do you want to
happen to your cremains?
- Do you wish for any honorary pallbearers?
- Any special music or prayers to be incorporated into the
- Any important preferences to reflect your religion or customs?
Privacy best practices
Due to the sensitive personal information contained in ECFs, it is essential to keep them secure and private. I suggest that you send them out as blank documents with envelopes. Each employee should be given clear instructions to complete the ECF in the presence of a spouse or close family member, put it into the provided envelope and seal it, then return it to the organization before a specified deadline. The sealed envelopes should be returned to a leadership group who can keep an inventory of who has been provided with ECFs, and who has turned in completed documents.
Due to the sensitivity of the ECF data, I do not recommend that they be stored with other, standard employee files. All agencies should abide by the rule that an employee’s sealed ECF is to be opened in only three circumstances: 1) in the event of that employee’s death; 2) if the employee is incapacitated to an extent that they are unable to speak for themselves; or 3) the employee wishes to update critical information in the ECF.
I’ll note in summary that the importance of having a comprehensive ECF program for your agency is twofold. First and foremost, it gives the leadership of your agency peace of mind and the ability to carry out necessary tasks when tragedy hits.
A secondary benefit for your employees is that it encourages them to speak openly with their loved ones about end-of-life issues — a conversation that many people tend to avoid. As a grief counselor, I have seen how difficult it can be for families and significant others to stumble through end-of-life and funeral planning choices in the midst of crushing grief. With an ECF in place, you can rest easy knowing that in a time of loss and sorrow, these important decisions will not have to be made in the shroud of loss and heartache.
In part 2 of this series, I will address another important step for agencies to take — assigning a family liaison who can help coordinate the many necessary actions following a LODD. In the meantime, may the wings of the ultimate chief pilot keep you all safe and with the faith that your agency, regardless of size, never has to experience a line of duty death.