Circumstances - Physician Assistant Education...
Transcript of Circumstances - Physician Assistant Education...
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Circumstances
• 31 year old female student on surgery rotation – Known medical issues – Immediate notification of program
• 31 year old male student on scheduled break between preclinical and clinical years – No known medical issues – Complicated death notification
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Initial Response
• Case I: family already notified by facility – Two faculty members to facility immediately – Students on site gathered in private space – SOM administration notified
• Case II: family notified by police – Hours between welfare check and
confirmation to program via Duke police and administration
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Student’s Loved Ones
• Case I – Met with family at hospital – Communicated by telephone and email prior to service – Designated family member – Call to family from Dean
• Case II – Communication by telephone – Designated family member – Call to family from Dean
• Ask about their needs from program; provide contact information
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Communication
• How and when people are informed is critical • Case I: Classmates either told in person or received
a personal phone call from a member of the faculty at their rotation.
• Case II: Classmates on campus. Communication to group as a whole.
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Utilizing Resources
• Campus police • Dean On-Call • Counseling and Psychological Services (CAPS) • Employee Assistance Program • Student life/Residence life • Chaplain
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College/university policies
• Crisis teams • Dean of Students and student affairs leadership • Academic Dean • Policies regarding student death
• Consider: – Meeting space arrangement – Nourishment – Excuses for affected students – Alternate living arrangements for impacted students
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Funeral and Memorial Services
• Communicate with designated family member • Provide information to students, staff and faculty
when known • Remove any barriers to attendance • Safe transportation • Participation in service as requested by family • Acknowledge emotion • Understand that some may not be emotionally
prepared to attend
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Funeral and Memorial Services
• Appreciate religious and cultural differences in memorials
• Family’s service and memorial is paramount • Memorials by students or university should not
eclipse or conflict with family’s service
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Awareness of Perceptions
• Provide truthful information quickly • Keep everyone informed • Expect confusion • Grief is individual as well as collective
– Communities of grief • Anger can be a part of grief • “Open doors” now more than ever
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Condolences
• Giving and receiving • Acknowledging students’ loss
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Group grief reactions
• Inoculation effect • Women may have more severe acute reactions to
peer deaths • Students who “know” deceased more likely to have
severe reactions • Prior trauma may exacerbate responses • Having a large network of friends may reduce
ongoing distress • Prior loss of close friend or family member may
mitigate acuity of reaction
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Individual reactions
• Can be affected by media exposure to deaths • Relatively few will take advantage of counseling
offered • Peer support matters • Isolation, pre-existing depression cause for concern • In some, may not be directly related to knowing
deceased • Nature of prior patient care experience • Cultural experience
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Talking about it
• Core themes: – Sadness – Helplessness – Guilt – Thinking about one’s own future – Already coping with loss – Helping the family of the deceased
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Kindness to one another
• Simply asking how students and colleagues are faring
• Accommodating curricular requirements for students • Understanding that there will be moments of great
sadness • Updating students and faculty as more information is
obtained • Anniversaries will be significant
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Symbolic remembrances
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Enduring remembrances
• Strivers’ Scholarship – Begun by a classmate of both students
• Fiona Lawrence Diversity Scholarship in Public Health Education (UNC-G)
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Graduation
• Acknowledgement of deceased student by classmates
• Invitation of loved ones • Honorary certificate
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Long-Term…
• Family may need your assistance or wish to maintain contact
• Continued work under high-stress conditions may increase student vulnerability after peer death
• Exposure to high levels of peer loss may be associated with chronic health conditions over life span
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References
• Andersen JP, Silver RC, Steward B, Koperwas B, Kirschbaum C. Psychological and physiological responses following repeated peer death. PLoS One. 2013 Sep 27; 8(9): e75581.
• Dean on-Call Manual, Academic Year 2014-15, Dean of Students Office, Duke University.
• Hart H, Garza Y. Teachers’ perceptions of effects of a student’s death: a phenomenological study. Omega (Westport). 2012-2013; 66(4):301-311.
• Hedman AS. Faculty’s empathy and academic support for grieving students. Death Stud. 2012 Nov-Dec;36(100):914-31.
• Jelllinek MS, Okoli UD. When a student dies: organizing the school’s response. Child Adolesc Psychiatr Clin N Am. 2012 Jan;21(1):57-67. • Jiang RS, Chou CC, Tsai PL. The grief reactions of nursing students related to
the sudden death of a classmate. J Nurs Res. 2006 (Dec);14(4):279-285. • Servaty-Seib HL, Peterson J, Spang D. Notifying individual students of a death
loss: practical recommendations for schools and school counselors. Death Studies. 2013 Oct 29; 27: 167-186.
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In Memoriam
Fiona Lawrence 1981-2012
Marcus Johnson 1981-2012