By Alex Nowak
On a typical day, the VCU Medical Center Emergency Department treats 300 patients. The department, a Level I trauma center geographically situated on the main corridor from Maine to Miami, sees some of the worst tragedies from up and down the East Coast: shootings, mass-casualty incidents, freak accidents, and multi-vehicle pileups. Despite every quick action and resuscitation effort made by medical team members, lives are lost and friends and families are left to grieve.
But for the medical team in the midst of a 12-hour shift, there is no time to grieve as their minds and bodies race to save the dying patient in the next bed. Operating in such a relentless environment can lead to exhaustion and burnout. With a recent study finding that nearly two-thirds of U.S. doctors feel burned out, depressed or both, something as simple as taking a moment to reflect after each patient’s death could not only allow providers to be more present for each patient, but build resiliency within the staff.
That is why Julie Kacmarcik, clinical coordinator in the emergency department, and a dedicated team brought the seemingly simple — but oftentimes difficult to personally justify — concept of “The Pause” to VCU Medical Center.
The Pause is 30 to 45 seconds of silence immediately after the death of a patient to honor his or her life, and distinctly mark the importance of the moment at hand. It is a brief timeout for everyone involved in the events leading up to the death to collect, reflect and help bring closure. Beyond that, it’s a moment to acknowledge the tremendous effort and care offered by the health care team.
“We’re looking at a person in a bed who didn’t plan on coming in to see us that day, and didn’t expect their life to be ending. This is a brother, a friend, a dad,” said Kacmarcik, a 23-year veteran of the emergency department. “And we acknowledge and recognize the team that gave their heart and soul to try and resuscitate this patient. It’s realizing that, yes, I’m thinking about all the other folks we have to take care of, but just for this finite period of time, I’ll be in the moment with this patient and with my team members.”
As Russell Davis, Ph.D., VCU Health director of pastoral care, puts it, “It is an expression of our humanity. It allows for silent expression of real human emotions.”