Jonathan Bartels is a nurse working in emergency care. He says witnessing death over and over again takes a toll on trauma workers — they can become numb or burned out.

But about two years ago, after Bartels and his team at the University of Virginia Medical Center, in Charlottesville, Va., tried and failed to resuscitate a patient, something happened.

"We had worked on this patient for hours, and the chaplain came in and kind of stopped everyone from leaving the room," Bartels recalls.

"She said, 'I'm just going to pray over this patient and then you all can leave,' " he says. "And I watched it and I felt ­— it was the act of stopping people that really inspired me."

Jonathan Bartels, an emergency care nurse at the University of Virginia Medical Center, recognized early the value of

Jonathan Bartels, an emergency care nurse at the University of Virginia Medical Center, recognized early the value of "The Pause." The practice is now part of the curriculum at the university's nursing school, and has begun to spread to other hospitals across the U.S.

Kara Lofton/WMRA

While the prayer wasn't totally comfortable to Bartels, because he, like many at the hospital, is from a different religious tradition than the chaplain, the act of pausing to pay silent respect and acknowledge the loss felt right.

"So the next time we worked on another person who didn't make it, I decided to be bold and stop people from leaving," he says. "I just said, 'Can we stop just for a moment, to recognize this person in the bed? You know, this person before they came in here was alive — they were interacting with family, they were loved by others, they had a life.' "

The team did it. Standing together silently, they stopped — just for a minute.

"When it was done, I said, 'Thank you all, and thank you for the efforts that we did to try and save them.' People walked out of the room, and they thanked me," Bartels says. "And they thought it was really awesome."

The idea of taking a moment of silence together after a death began to spread to other teams throughout the hospital — other emergency workers picked it up, as did an anesthesiologist and a surgeon. What's come to be called The Pause is now being taught as part of the curriculum at the university's nursing school. Emergency medical technician Jack Berner says it helps him handle the toughest cases.

"It makes it so we can actually view the person as a person, rather than as a patient that we see on an everyday basis," he says. "You can relate more to the case, [knowing] it's somebody's father or their mother, their sister or their uncle, rather than somebody you just see for five minutes."

Bartels hopes The Pause will help medical workers like Berner acknowledge and accept the loss without disconnecting emotionally.

"So you are able to feel, and you are also able to sense and give back," Bartels says. Even if the person who died wasn't a relative, health workers share some of the pain in the loss of each life — and need to be able feel it, but without being overwhelmed.

"I can also acknowledge the pain that I bore witness to, in caring for that family, and caring for that patient," he explains.

The concept is spreading beyond the University of Virginia. After the dean of its school of nursing talked about the practice in a speech at a national conference, a nurse from Providence Sacred Heart Medical Center took it home to her co-workers in Spokane, Wash.

This story is part of NPR's reporting partnership with local member stations and Kaiser Health News.

Copyright 2015 WMRA-FM. To see more, visit http://www.wmra.org.

Transcript

ARUN RATH, HOST:

Facing death head-on is a job requirement for many medical workers, but it's harder to prepare for the emotional toll. WMRA's Kara Lofton reports on an initiative called The Pause that started at the University of Virginia Medical Center two years ago and is slowly being adopted by hospitals all over the country.

(SOUNDBITE OF BEEPING)

UNIDENTIFIED PEOPLE: (Unintelligible).

KARA LOFTON, BYLINE: These are sounds from a training at the University of Virginia Medical Center. Students are practicing for that moment when a patient is in the space between life and death. In a real situation, sometimes the medical workers are too late, or the patient is too sick and dies. After a loss, the team puts down their tools, cleans up and moves on. There's always someone else who needs saving.

For nearly a decade, variations on this scenario where the reality of Jonathan Bartels, a nurse working in emergency care. He says witnessing death over and over again wears on trauma workers. They often become numb or burned out. But about two years ago, after Bartels' team tried and failed to resuscitate a patient, something happened.

JONATHAN BARTELS: We had worked on this patient for hours, and the chaplain came in and kind of stopped everyone from leaving the room. And I'm like wow, that's really bold. And she said, I'm just going to pray over this patient, and then you all can leave. And I watched it, and I felt it was - the act of stopping people really inspired me.

LOFTON: The prayer wasn't totally comfortable to him because Bartels, like many at the hospital, is from a different religious tradition, but the act of pausing felt right.

BARTELS: So the next time when we worked on another person who didn't make it, I decided to be bold and stop people from leaving. I just said, could we stop just for a moment and recognize this person in the bed? You know, this person, before they came in here, were alive. They were interacting with family. They were loved by others. They had a life.

LOFTON: The team agreed.

BARTELS: When it was done - and I only did it for about a minute, and then I said thank you, all, and thank you, all, for all the effort that we did to try to save them - people walked out of the room. And they thanked me, and they thought it was really awesome.

LOFTON: The idea began to spread throughout the hospital, particularly to emergency department workers. EMT and hospital tech Jack Berner says it helps him handle the toughest cases.

JACK BERNER: You know, it's somebody's father, their mother, their sister or uncle or - rather than just somebody you just see for five minutes

LOFTON: Bartels' vision for The Pause is that it will help medical workers like Berner accept the loss without disconnecting emotionally.

BARTELS: So you're able to feel, and you're also able to sense and give back. The best way to cope with that in a healthy way is you acknowledge your feelings when someone dies. You acknowledge the pain of that, but we don't own that. That's not my death. That's not my family, but I can acknowledge that this is a natural process, and this is what happens. And I can also acknowledge the pain that I bore witness to in caring for that family and for that patient.

LOFTON: The concept is spreading beyond UVA. After the Dean of UVA's school of nursing talked about the practice in a speech at a national conference, a nurse from Providence Sacred Heart Medical Center brought it across the country to Spokane, Wash. For NPR News, I'm Kara Lofton.

RATH: This story is part of a reporting partnership between NPR, local member stations and Kaiser Health News. Transcript provided by NPR, Copyright NPR.

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