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When EMS meets hospice

End-of-life care takes a heavy emotional toll: Seek support when needed


“We acknowledge that taking a hospice patient on their final ride can be a heavy emotional task. There’s no avoiding this sad reality. It can be heartbreaking.”

Photo/Will.alexander, Wikimedia Commons

By Jeff Czyson, Nikki Holm and Russ Myers

At first glance, the worlds of EMS and hospice appear to be miles apart. EMS, as its name implies, is focused on emergency care. In hospice, the focus shifts from cure to comfort at the end of life.

Modern EMS has a wide scope of practice which includes scheduled, non-emergent care. Our interfacility and critical care crews skillfully transport patients by ambulance between healthcare facilities, and from medical centers to home. It is here that we see the intersection of EMS and hospice, when EMTs and paramedics take hospice patients home: home to die.

Even for the seasoned hospice provider, caring for patients and their loved ones at the end of life can be emotionally and spiritually exhausting. From the EMS perspective, there is the added need to shift our mindset back and forth with each call. One patient is moving between facilities on the road to healing and recovery. The next is going home to die. How do we even begin to take that in?

We acknowledge that taking a hospice patient on their final ride can be a heavy emotional task. There’s no avoiding this sad reality. It can be heartbreaking.

For many hospice patients, their strong desire and hope is to die at home, in their own bed, saying good bye, surrounded by loved ones. Often, the only way they can get home is by ambulance. As hard as it is for us, it means the world to those patients and their families to be at home during this sacred time.

This is stressful work. It is different from a heart-pumping, adrenaline-fueled 911 call, but stressful in its own way. Emergency calls and scheduled interfacility calls have this in common: they bring us face-to-face with the hard realities of human suffering.

Healthy ways to cope with grief

Our response, then, isn’t all that different. When faced with uncomfortable emotions or reactions, we have the option to numb out, bury our feelings, bottle it up and carry on as if it doesn’t bother us. We also have the option to talk it out, share our stories and our grief with valued peers and other trusted people.

When we acknowledge these uncomfortable feelings, there is support available. This could be conversation with your leader, peer support, your organization’s employee assistance program, chaplains, debriefings, referral to clinical professionals and other local resources. We know this noble work can take a heavy emotional toll, and we encourage you to take care of yourself and seek support when you need it.


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About the authors

Jeff Czyson is director, EMS Workforce, and Nikki Holm and Russ Myers are chaplains, and part of the employee wellness team at Allina Health EMS, based in Minneapolis-Saint Paul, Minnesota.

Russ Myers is a chaplain with Allina Health EMS, St. Paul, Minnesota, and author of “Because We Care: A Handbook for Chaplaincy in Emergency Medical Services.” He can be contacted at