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The Question
by EMS1 Community

How do paramedics get over the guilt of failed rescue after patients pass away?

Read the response and add your own thoughts in the comments

A question posted recently on Quora asked "How do paramedics get over the guilt of failed rescue after patients pass away?" EMT Jon Frattaroli gave his opinion on the topic. Read his response, and add your own to the comments. 


I've been an EMT for nearly 10 years and I have unfortunately had people die in my arms, but the answer to your question greatly depends on the situation. 

For example an 80-year-old person who has a heart attack and dies generally does not affect a professional EMT or Paramedic as its the natural course of life.  Yes we would like to save all of our patients, but sometimes its just not possible and elderly deaths are just part of the job. 

On the other hand if I lose a young person it can be very difficult to get over. 

While most people in Emergency Services have "seen it all" anybody who has a young person die in their ambulance is usually affected by it ... sometimes deeply. To get over it we talk to our crewmates and sometimes to professional counselors, depending on the severity of the call. Personally, when I lose a young patient I tend to hug my wife and kids a little more than normal, but it can take me months to stop thinking about those failed rescues.

About the author

"The Question" section brings together user-generated articles from our Facebook page based on questions we pose to our followers, as well as some of the best content we find on Quora, a question-and-answer website created, edited and organized by its community of users who are often experts in their field. The site aggregates questions and answers for a range of topics, including public safety. The questions and answers featured here on EMS1 are posted directly from Quora, and the views and opinions expressed do not necessarily reflect those of EMS1.
The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
David J. Givot, Attorney at Law David J. Givot, Attorney at Law Thursday, April 17, 2014 10:46:15 AM Wise words. Thank you. I think it is essential to remember that, where one does all that one can do, loss of life does not equate to a failed rescue.
Gene Iannuzzi Gene Iannuzzi Sunday, April 20, 2014 12:05:34 PM perhaps my analogy is less than eloquent, but i think of it as a player at a gambling table. you can play the hand you are given, but you dont get to deal the cards. my own spiritual view of the world has been that i am but a player whose task it is to do his very best. the creator is the one who deals the cards and who knows the answer to how it all fits together.
JeremiahandJennifer Underwood JeremiahandJennifer Underwood Sunday, April 20, 2014 12:08:23 PM I used to have a very hard time when a patient died, especially a younger person. Now that I am a Christian, I have come to understand that it's not up to me who lives and dies. I do the best I can and leave the rest to God.
Jeff Robertson Jeff Robertson Sunday, April 20, 2014 12:10:17 PM I don't think that I ever truly stop thinking about it honestly. I can still see faces and remember names to this very day. I, too, huge my family and kids just a little bit tighter. I have other outlets as well, sports and outdoor activities allow me to release the stress but I don't know if it ever truly goes away. I look a life a bit differently and I celebrate it no matter how long or short it is. I do what I can and beyond that, I believe it's out of my hands. If you do everything you can, within your ability, and the patient still passes then maybe that is beyond us? You know what I mean?
Mar Davis Mar Davis Sunday, April 20, 2014 12:21:03 PM We don't, we learn to deal with it.
James Tourville James Tourville Sunday, April 20, 2014 12:38:10 PM I look at it this way. I feel that I didn't make the problem, I am doing my best to correct it. If I don't do my job someone else has to. What we feel and think are only normal. Tue only rough spots for me are the snap shots we take with our mind! Peace brothers and sisters.
Ellen Kraus Ellen Kraus Sunday, April 20, 2014 12:38:14 PM I was older than most and had some life experience when I got into fire, police and is never easy to see someone die, but I have been raised by my grandparents, and we had farm animals - killing for food and death was something I learned about early on. When I started working in EMS, fire and police I noticed a lot of the younger co-workers have never been in a fist-fight or seen anyone die - they were shell-shocked at times to see blood, and froze when someone was dying. They need to be prepared for this, the same way someone gets sent to war and sees carnage. Some get used to it, some burn out, many quit. Then there is PTSD in these professions - people have gotten a bit softer thru the years, the younger generations are a bit numbed by TV and games, and take a while to digest the real thing.
Leif Orr Leif Orr Sunday, April 20, 2014 12:47:28 PM When I was a rookie all patient fatalities were difficult and left a huge wound. Over time it still hurts, but I have learned that if you gave it all you had, that you have done your best. Sometimes your best isn't enough. I, now, look at death as just a part of life. Even though some days it hits a little harder than others, I find solace in knowing the we at least gave it our best. I still internalize it when I lose a child, but I do eventually find peace.
Lisa Sheryl Kissel Lisa Sheryl Kissel Sunday, April 20, 2014 12:52:00 PM One can never be immune to feelings and pain of Losing a young patient in the ambulance . That is part of being Human.
Isabel Archer Isabel Archer Sunday, April 20, 2014 1:05:34 PM I ran a difficult call and I'm still a student. It involved a child who had already been dealt a bad hand. In a time like that I could see on both sides of letting them go peacefully and trying to keep them with us. You never forget those calls.
John-Anthony B. Muna John-Anthony B. Muna Sunday, April 20, 2014 1:21:34 PM it's never a failed rescue or attempt if you did your job competently and confidently. . most times it just is.. unfortunate. .
Warren Brown Warren Brown Sunday, April 20, 2014 1:22:33 PM I trust in God, and I believe He expects me to use the skills and abilities He has blessed me with to do the best job I can. But at the end of the mission, He gets to make the ultimate decision of life and death. I sleep at night and live with myself by knowing that I have done everything I could have possibly done, with no regrets.
Meriah Powers Meriah Powers Sunday, April 20, 2014 1:30:02 PM Some bother me and some dont. Some 8 can notify the family and not she'd a tear or even blink an eye. Not because I am callus or mean that's just how it is. Having an elderly person or someone with a terminal illness die is so very different then a young or violent death. I may be crazy but sometimes I swear if the death was sudden or traumatic I can actually feel the spirit of the person in the room in the car or in the ambulance and I feel sometimes as if they are actually watching over my shoulder as I try to save them. Other times I walk into a house or a room and can tell instantly there seems to be no presence and the patient is gone..I am not clinically speaking but speaking for of feelings inky. I am not a religious person I was not raised that way. I do feel like in my mind I have files that I like to keep tucked away sometimes they come out.. I see faces I see bodies I smell the smoking car I hear the screaming of families. Yes sometimes it is hard to deal with. I do speak with my crew members or I have spoken to a counselor many times. It does feel much better to talk with a counselor and get it off my shoulders then I can tuck it away in my little file.
Ashley Six Ashley Six Sunday, April 20, 2014 1:34:16 PM You never really forget the failed rescues you have in my opinion. You still remember things and sometimes even faces. Maybe not the face of the victim sometimes it's the families faces that stick in my mind but some face or moment remains frozen in time filed away in my mind. I tend to draw away from people for a while to give myself the time to rehash what I did and convince myself I couldn't have changed the outcome. I have my outlets for venting the stress and pain. I think one of the best outlets I have is the chance to relax and go hiking or canoeing. Being away from it all sometimes clears the mind better than anything else. I find that in the wilderness I am closest to God and can turn to him for the healing and reassurance I need. I guess it's all about realizing that you did your best and it must be the will of God, you can't change that.
Stephen Hudspeth Stephen Hudspeth Sunday, April 20, 2014 1:42:02 PM That's a great way to look at it!
Teri Lynne Miller Teri Lynne Miller Sunday, April 20, 2014 1:45:00 PM I think it starts with your attitude towards "saving lives" in the first place. MY grandmother was an RN, a calling from her god to serve. She once told me that she did not "save lives", only god did. That she was," but a tool", and because nursing was her god given calling she felt obligated to serve to the best of her ability and be the best tool for the hand of god that she could be. I'm uncomfortable when people talk about saving lives. I get bummed when someone dies but I feel no more responsible for the death that I do the saving of a life. In EMS I have seen miracles...people that should have died and didn't. It just confirmed what granny told me when I was very little. "Only god decides when it is time to go". I'm not as religious as my grandmother would like me to be, but I do believe that statement and I believe it does help me cope with what other get burned out by.
Mark Garner Mark Garner Sunday, April 20, 2014 2:09:18 PM After 18 years as a paramedic I honestly have to say its got harder to deal with now that I have a young family and witnessed a parent passing away but in some ways I think that's good. Being emotionally num can't be a good thing. Accepting that death is just part of life def helps as does having a faith knowing there is an afterlife.
Jennifer Brunett Jennifer Brunett Sunday, April 20, 2014 2:17:22 PM It's never a failure, as long as you did your best. Not everyone will survive. Even the heroes medics think they are sometimes can't cheat death and win every single time. That's just reality. If we are lucky, as EMS providers, we're in the right place at the right time and can make a difference.
Scott Melling Scott Melling Sunday, April 20, 2014 2:51:35 PM I feel the same as your grandmother. God placed me in EMS for a reason. I've been serving for 28 years now; being used to ease pain and suffering. Sometimes I am part of great things and other times I am the messenger of sadness. I have become very skilled at reading people and emotions, knowing when and how to offer the right word or touch at a given moment. Each person has to find their own way of dealing with these outcomes. Faith, family, friends and experience has helped me effectively manage my feelings. I have no "guilt" when the outcome is negative because I know I've done the best I can with the skills and knowledge I've been given.
Cameron Roberts Cameron Roberts Sunday, April 20, 2014 5:51:33 PM As soon as CPR begins, in my head they are dead. I acknowledge that. We will try all the drug therapy and electrical therapy or interventions we can. If we get them back it's akin to Dr. Frankenstiens expirement. It is a truly magnificent thing to bring someone back. But when we statistically speaking likely will not revive them, it is easier for me to remember they are all ready gone.
Joey Johnson Jr. Joey Johnson Jr. Sunday, April 20, 2014 6:55:59 PM And I'm an atheist, and I understand I can do my best too.
Mark Dewdney Mark Dewdney Sunday, April 20, 2014 8:15:34 PM I remember the face of my first CPR victim (and my first "save"), but not any after that. I don't hide from it, but I think my subconscious has adapted very well. It's the "clear and present" memory immediately after a scene that seems to hit - otherwise, I'm saddened, I'm sobered, I feel it (checked with a psychologist to make sure!), but it takes something large-scale to get me "off my stride". I suppose that a) I'm lucky that way, b) that I haven't seen as much as some surely have and c) I'm also sure that, when I retire and have "too much time on my hands" that I'll think some more about it. My point? I think some people ARE "wired" for it, and we might go as far as to alter our minds (hopefully sans chemicals) - adapt to it, by any other name - and I think it's OK to not feel the same things as everyone else. That's important too, to give yourself permission to bounce back without having it lay on you like a ton of bricks forever.
Tim Thomas Tim Thomas Sunday, April 20, 2014 9:24:03 PM I had a harder time with bad calls until I STOPPED being a believer in any god etc. I always had the "what loving god allows this innocent 6 month old get shot..." type stuff. Am glad it helps you though. The common thread seems to be the realization that we as EMS caregivers are just charged with educating ourselves and doing our best. We cant decide who lives or dies. Best Wishes J+J!!
Tim Thomas Tim Thomas Sunday, April 20, 2014 9:30:40 PM One of the best ways I coped was to try and realize that maybe the patient died, but my crew and I did our best to make a chaotic and emotional situation much less so. AND we usually helped family and loved ones of the deceased through that rotten situation in ways we cannot imagine. Personally, I had to drop any faith I had in any religion because it created more pain and confusion inside my own mellon. Maybe it wouldn't have been that way if I hadn't studied the bible and the history from the time it was written for 4 years at the college level. I do know many providers however who can take comfort from belief in a deity.
Tacienne Lapointe Tacienne Lapointe Sunday, April 20, 2014 10:54:29 PM I am a Roman Catholic and a ferm believer.... God does not ```make`` innocent victims but ''allows'' that to happen so they can partake in his redemption maybe even saving the soul of their own executionner.... God isn't the one that shot the innocent 6month old but somebody who clearly doesn't have any morale.... The Loving God that allows innocents to suffer and walk in his steps for a short time here on earth before giving them eternal joye in Heaven is the One that has shown us the way leading it up himself by his sacrifice on the Cross even if he was Innocence itself? He is known as the MAN OF SORROWS.... Suffrance isn't something you can understand unless you look at it from a higher level..... ''it is the thorns that guard the roses'' ( St Theresa of the Child Jesus) And I had my share of shitty situations when all I could do was sit there and listen to life draining out bit by bit... It is never easy and it will always haunt me but I believe that everytime I offer it up in union with Christ's sufferings, He is able to turn bitterness into so much more through the power of Grace and real Love, Charity.... By the power of Charity, day to day actions can have an eaternal value and repercussions one has no idea of during this life.... May God Bless you who try every day to do his will even if you don't understand it at all... One day he might let you see his grace in action through your very own efforts....
Chester Brown Chester Brown Monday, April 21, 2014 3:18:53 AM It is very important to understand you did not cause the problem. You are only trying to make it better. Some you win, some you don't. You did not cause it.
Mario van Limburg Mario van Limburg Monday, April 21, 2014 4:13:19 AM I think we give them a change, with all the power and equipment and energy we have, sometimes it's just over, timetable ends. I believe everyone has an own timetable. Coming and going at any age, independent of the knowledge we have.
Jake Hammonds Jake Hammonds Monday, April 21, 2014 6:33:10 AM In school my instructor taught me two things. 1) you can't save everybody. Sometimes it's just their time. 2) We can't change rule one.
Dana Swift Dana Swift Monday, April 21, 2014 9:36:01 AM You never really get used to it no matter how many years you do it. Accept that life is short, temporary and fragile. I've been in this business since 1988 in some capacity (Firefighter, EMT, Paramedic, now ICU/ED RN and Federal Disaster Medical Responder). I recently had a pretty overwhelming PTSD event which required some aggressive counseling (both formal and almost more importantly, informal with fellow firefighters/paramedics/medical personnel). The irony was the trigger wasn't work related but it brought out an enormous amount of cumulative stress that I thought I had adequately dealt with.... There is a fine line between talking to someone about how a certain call made you feel and re-traumatization - beware of this. That said, CISD and diffusing is just a Band-Aid unless that's all you need to recover from a loss (which isn't likely). Get help and never be afraid to acknowledge your own fragility. This is grief work as much as it is anything else and it is OK to take time to grieve. Lastly, remember to remind those you love, just how much you love them - don't miss a chance.
Laurie Jo White Laurie Jo White Monday, April 21, 2014 10:41:14 AM Paramedics aren't the only ones who struggle to get thru the guilt. So are AEMTs and EMT's. I'm very lucky where I am, in a rural area, that I have great co-workers who support and help each other during these time. Usually, 9 times out of 10 it's someone that one of us knows and that makes it tougher. I don't think we get over it, we just learn how to deal with it.
Ronnie Martin Ronnie Martin Monday, April 21, 2014 10:35:44 PM The way I have always handled this question is that God gave me the skills to do my job. God is the final say on who lives and who dies. If I did my job to its fullest and the patient passes, I would say a silent prayer, close the patients eyes and understand that God decided that he wanted this patient in Heaven. We are not gods in the pre hospital world, we are mere players. God will always be the final answer.

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