Surgeon and medical student response to patient death

Brianne Wiemann; Erika Ketteler; Bridget Fahy

doi:10.21037/apm-22-885

Surgeon and medical student response to patient death

Ann Palliat Med. 2023 Jan;12(1):70-80. doi: 10.21037/apm-22-885. Epub 2022 Dec 27.

Authors

Brianne Wiemann¹, Erika Ketteler², Bridget Fahy¹

Affiliations

¹ Department of Surgery, General Surgery Division, University of New Mexico School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA.
² Department of Surgery, Vascular Surgery Division, Raymond G. Murphy Veteran Affairs Medical Center, Albuquerque, New Mexico, USA.

PMID: 36627848
DOI: 10.21037/apm-22-885

Abstract

Background: Virtually all surgeons will experience patient death in their practice. Despite this, little is known about how surgeons cope with patient death or its potential adverse impact on surgeons' well-being. Education on how to respond to loss is not often incorporated into current wellness curricula in surgical training. In light of the ongoing COVID-19 pandemic and the significant hospital-related mortality, understanding surgical provider response to patient loss takes on unique import.

Methods: A retrospective analysis was performed following administration of a 10-item survey that assessed healthcare provider (HCP) experience with patient death, activities used to cope with patient loss, and symptoms HCPs experienced. Participants included surgical faculty, residents, surgical advance practice providers and medical students on their surgical clerkship. Demographic characteristics were recorded: age, gender, academic level. Chi-squared test or Fisher exact test compared proportionality between those that did and did not experience patient loss. Logistic regression generated odds ratios examining impact of patient loss on symptoms experienced and activities engaged in after patient loss.

Results: Fifty-six (75%) respondents experienced patient death. Common responses were to talk with colleagues (71%) and seek comfort from family/friends/partner (55%). Most respondents did not report symptoms related to patient death (53%); burnout was the most common symptom reported (36%). Respondents were less likely to seek interpersonal support for COVID-19-related death (P<0.008). Only 49% of participants received education on coping with patient death.

Conclusions: Few surgeons receive training related to patient death. Optimal coping strategies are unknown but may mitigate potential negative impacts, including burnout. The data presented here also suggests the need to establish medical education designed to mitigate the distress associated with patient loss.

Keywords: Burnout; patient death; research education; surgeon wellness.