The IU Emergency Medicine residency program is over 40 years old and we have an amazing network of alumni around the world who are working diligently to improve emergency care and patient outcome. Dr. Sandy Indermuhle is a prime example.
Sandy has provided innovative leadership in addressing opioids, mental health, and ED provider resiliency, and recently received grant funding to support this work. When a patient requires the use of naloxone in the ED (or is identified as being at risk), her ED has taken it a step beyond a social work or treatment referral. A trained support peer (prior user) comes to the ED to assist intervention with the patient and family. If the patient is ready for treatment, they are enrolled in an appropriate inpatient or outpatient program. If not, they are referred to a harm reduction program to decrease the likelihood of unintended overdose. This couples with periodic phone follow-up for the following year.
In addition to her work related to opioids and mental health, Sandy is also leading a study aimed at decreasing ED provider burn-out involving how physicians respond to death in the ED. In addition to the “post code pause” incorporated in many emergency departments, they have instituted a “line-up” called “The Pause,” which is similar to what the organ donor network does with patients on the way to the OR. Available staff join a line-up in the hallway and wheel the deceased patient, with family and friends following, down the hall to the holding room. This has proven to be a nice way to take a moment to honor the patient, family, and staff. On occasion, EMS crews, police, and other ancillary staff also join these line ups. The feedback has been positive from the prehospital crews and families.
Continue reading to find a transcript of “The Pause” (mentioned in the paragraph above).
Could we take a moment just to pause and honor this person,
(Say patient’s name if known).
This was someone who was alive and now has died.
They were someone who loved and was loved.
They were someone’s friend and family member.
Not only did we bring our clinical skills, we also brought our humanity, shared dignity, and respect for someone entrusted to our care.
In our own way, and in silence, let us stand together and take a moment to honor both this person before us and all the valiant efforts that were made on their behalf.
(10-30 seconds of silence, as long as comfortable)
Thank you everyone who came to offer their help and support.”
To be read by staff in room after a code or withdrawal of care. Please document on Code Blue Sheet if The Pause was done. Okay to add personal touch, if desired.
Written by Dr. Carey D. Chisholm, Professor Emeritus of Emergency Medicine