Internal Affairs: Communicating During a Tragedy

On April 28, 2004, at 3:06 p.m., Southwest Ambulance AP44 was transporting a patient from the Florence, AZ, prison complex to a local hospital. It was running without lights or siren. EMT Tammy Mundell was driving. In the back were medic Sandra Williams, the patient and a corrections officer. The ambulance was struck head-on by a gravel-loaded dump truck. Tammy, who was eight months pregnant, was killed, along with her unborn child.

     Tammy's and Sandra's coworkers were first to arrive on the scene. Alerted to the accident, news helicopters broadcast live coverage. Television ground crews arrived soon after.

     In the event of a tragedy like this, EMS agencies should have separate crisis communications plans for the media, families of any deceased, families of those who are injured and the workforce as a whole. This article focuses on communicating with families and coworkers.

     WHEN A PROVIDER IS KILLED
     There are several steps organizations should take to handle such tragedies appropriately. These are outlined below. They are supplemented by the personal experiences of those of us at Southwest Ambulance who suffered the loss of our colleague Tammy Mundell.

Organize a Team
     Organize a team before going to see the family. Decide in advance who will tell the family what has happened. If members of the team drive separately, they should arrive at the family's home at the same time. You don't want team members lingering outside the home, waiting for others to arrive. This is particularly true if the family is unaware of the accident.

     Our experience: All executive managers were paged. They, in turn, called our vice president of operations. The human resources vice president retrieved the employment files of both victims. Our team consisted of the human resources VP, another senior executive, the local union president and a member of the union's executive board.

Talk in Person and in Private
     If possible, talk to family members in person in their home instead of over the telephone. Take the spouse aside and tell them first. Let that person tell other family members.

     Our experience: Tammy's coworkers had already called the house and told the babysitter Tammy had been in an accident. They did not know she had died. The babysitter called Tammy's husband. Our team met the husband at the home and talked to him. He told his five children.

Provide Regular and Consistent Updates
     Designate a liaison between your team and those on the scene. This will facilitate clear communication. Tell your dispatch center or other main contacts what to tell concerned coworkers or the families of employees who want to know if their loved ones were involved in the accident.

     Our experience: After the family was informed, the on-scene PIO was given permission to release Tammy's name prior to the evening news cycle. With more than 1,000 Southwest employees in Arizona, we wanted to allay concerns among people's family members. Our dispatch and scheduling office was also told. We did not release information regarding Tammy's pregnancy or her five children until the conclusion of the evening news cycle.

Obtain a Family Photograph
     Rather than using a company photograph, ask the family for a favorite family picture that can be disseminated to media.

     Our experience: Tammy's husband provided a family portrait. It was scanned and distributed to media via e-mail. In the message accompanying the picture, we announced her pregnancy and five children. Disseminating the family portrait quickly communicated the kind of person Tammy was. It helped rally community support for her family.

Accommodate Family Requests
     To the extent possible, accommodate the family's requests.

     Our experience: Tammy's husband insisted on going to the scene of the accident to see her. He was taken there later that evening. Media representatives at the scene did not realize who he was and did not photograph his visit. A grief counselor and pastor were also sent to the scene to provide assistance.

Collect Personal Effects Quickly
     Arrangements need to be made to return the personal vehicle and other effects to the family as quickly as possible. This is important to both the family and coworkers.

     Our experience: The replacement crew at Tammy's station did not feel comfortable staying at the station that night with her belongings still there. We posted the crew at another location until her personal effects were removed and returned to her family.

Protect the Family From Media and Friends
     Pending other arrangements, one or more of your team members should serve as a gatekeeper to ensure the grieving family's privacy. Offer to screen phone calls and visitors. Maintain a list of those who call or visit for the family's later reference.

     Our experience: When the husband returned home, a TV news crew was present. Our team told the news crew that the family would not be making a statement. After our team left, a different television reporter knocked on the door. In hindsight, a note should have been left on the door indicating that the family had no statement at that time.

Continue to Provide Support
     Throughout the week following a tragedy, at least one of the team should offer to remain with the family to provide follow-up assistance.

     Our experience: With permission from the family, two members of the team made funeral arrangements. A complete IAFF line-of-duty-death ceremony, with bagpipes and colors, was also organized. More than 500 people attended Tammy's funeral. More than 50 pieces of apparatus from EMS agencies around Arizona were displayed. A reception following the service was held in our corporate building to accommodate the large number of mourners.

Do Not Make Things Worse
     If you learn of something that may occur that might cause more harm than good, discuss your concerns with other senior staff.

     Our experience: Several days after the tragedy, Tammy's family had yet to make a public statement. However, in an effort to assemble a record of the news coverage that had occurred, the family contacted several local television stations. At its request, the family agreed to an interview with one station. The team member at the home contacted our PIO to alert him to that fact. The PIO subsequently spoke with the family and received permission to invite all media for a onetime interview. The goal was to protect the family from what would otherwise have become a string of redundant interviews. The PIO also prepared the family for the kinds of questions to expect so members could decide what information they did or did not want to provide.

WHEN A PROVIDER IS INJURED

     Most of the media's attention after the crash was devoted to Tammy. Fewer people took an interest in injured medic Sandra Williams. She was in the hospital in serious condition. There was concern she might also die. We almost lost her twice.

Remember the Injured
     While your primary team sees to the needs of the family members of the deceased, family members of injured coworkers need to be treated with equal respect.

     Our experience: Our union president reached Sandra's husband by telephone and asked him to go to the hospital to which she'd been taken. He was greeted by a district manager, who was assigned to stay with him and Sandra's family. The manager was the family's primary contact the entire week.

Respect the Family's Wishes
     The family has many decisions to make. Presenting its members with alternative courses of action can be helpful. However, once family members make a decision, their wishes should be respected.

     Our experience: Sandra's husband did not want her name released to the media. We asked permission to share her name with coworkers because they were concerned. This was granted.

Share Good News
     After bad news, it's important to share good news. This provides employees with something positive to focus on during the days following a tragedy.

     Our experience: Sandra was transferred out of the intensive care unit 19 days later. She was quickly regaining strength. We were given permission by the family to share this news with her coworkers and the media.

Celebrate a Recovery
     An injured worker benefits from an encouraging return home.

     Our experience: When Sandra was finally released from the hospital, she wanted to talk to the media to thank everyone for their prayers and support. On the day of her release, a press conference was held in the hospital lobby. Sandra was surprised to see 75 coworkers greeting her with balloons, signs and cheers.

     Her limousine ride home was escorted by two ambulances. Sandra and her husband counted two dozen ambulance and firefighting crews waving to her during their half-hour journey.

     COMMUNICATING WITH EMPLOYEES

Send a Consistent Message
     Whether directed toward media, employees or families, choose one consistent message and stick with it.

     Our experience: Many of our employees heard about the accident on television. Our message was simple: The Southwest Ambulance family is devastated by the loss of Tammy. Employees began to refer to their coworkers as family. The media and community at large began to echo those sentiments.

Put Your Key People in Place
     Make sure everyone on your management team knows where they're supposed to be and what they're supposed to do.

     Our experience: Our executive and senior managers were informed of the tragedy within minutes. Off-duty district managers were paged and also given assignments.

     Ironically, earlier that day, one of Southwest's vice presidents had held a meeting with a group of professional grief counselors to discuss the feasibility of entering into a service agreement with them in the event of a tragedy. They were contacted within two hours of the accident and sent to different locations to offer assistance to staff.

Prepare Pages in Advance
     In anticipation of a tragedy, you can prescript and save the contents of a future pager message. As subsequent events warrant, you can add the names of any victims, general details of what occurred and a call to action.

     Our experience: A page was sent to all employees within three hours of the accident. With her family's permission, Tammy's name was released. Employees were told what they could do to help and where they could go to grieve.

     The hospital where Sandra was taken became a meeting place for her Phoenix-area coworkers. Dozens of off-duty staff members visited a special room where managers could share what was known. Counselors were also available. During a tragedy, coworkers want to be together. Give them that opportunity.

Inform On-Duty Crews
     Inform your on-duty employees of a tragedy before the local hospital or fellow EMS workers inform them.

     Our experience: In addition to the aforementioned page, district managers visited on-duty crews to alert them to the accident and answer their questions.

Establish an Employee-Only Telephone Hotline
     Establish a private telephone line for the exclusive use of employees who want to obtain information about the accident and the condition of those injured.

     Our experience: Our Information Systems Department set up a telephone line. A recorded outgoing message was updated as new information became available. The telephone number was sent by page to employees. It was also posted on the employee intranet site.

     Every recorded message began the same way: "The entire Southwest Ambulance family is devastated by the loss of 29-year-old EMT Tammy Mundell. This message was last updated at [time]. This telephone line has been created to keep you, our employees, updated. We ask that you not share this telephone number outside the Southwest family."

Establish an Employee-Only Intranet Site
     If you have an employee-only or password-protected website, use it to share information.

     Our experience: Southwest has an employee-only intranet site. It was used to provide timely updates on the accident. We were able to provide more information on this site than we were on our telephone hotline.

Provide Regular Updates to Other Management
     Keep your organization's entire management team informed.

     Our experience: The morning following the accident, we held a management briefing. Not only was this necessary from an operational standpoint, it was also helpful emotionally. It was an opportunity for those in attendance to discuss what had occurred.

     Organize Formal Public Displays of Sympathy
     Many employees will want to demonstrate their sympathy and grief. Ensure these displays are uniform companywide. After a sufficient passage of time, all such displays should be removed at the same time.

     Our experience: A strip of black tape was placed over our company logo or over the unit number on all 225 Southwest Ambulance vehicles. Small black ribbons were worn on shirts. At the same time it was announced that all of the strips and ribbons would be removed on the Friday following the funeral. Providing an exact date in advance allowed for the timely and consistent removal of the displays.

Establish a Fund for the Family
     Establish a fund so community members and coworkers can make financial contributions to the victims and their families.

     Our experience: A fund was established through a local bank to receive donations. The account's creation was announced to employees and through local media to the community at large.

Provide Employees With Positive Outlets
     Many employees will want to do something. Organize and channel their energy in a positive direction.

     Our experience: Our union hosted a number of car washes that the company promoted online. Over the following two weeks, numerous car washes and other fundraising efforts were successfully held by the union. One raised more than $9,000.

Establish an External Website
     As the local and national EMS communities learn of a tragedy, they will go to your website to learn more. Use your website to inform them.

     Our experience: Our external website featured a picture of Tammy. Information for those wishing to contribute to the family fund was also provided. Our webmaster created a message board that saw nearly 300 messages posted from coworkers, families, friends and strangers around the country.

     Tammy's picture remained on the opening page of our website for one week following the funeral. The page was subsequently shifted to a prominent link on the front page. The message board was closed several weeks later. Several months later, the link was moved to a permanent page within the website that is dedicated to those lost in the line of duty.

Share Funeral Arrangements
     Even if specific details have yet to be finalized, provide the information as soon as it becomes available. Coworkers who worked with the deceased should receive special respect during the formulation of funeral plans.

     Our experience: Those who worked with Tammy were invited to serve as members of the funeral color guard. Other staff members were assigned to cover their work shifts. We provided details about the funeral as early as possible so our employees knew Tammy and her family were receiving the utmost respect.

Change the Tone From Devastation to Inspiration
     After the initial shock wears off, provide more upbeat messages on your employee telephone hotline. Include forward-looking phrases on your internal website. Incrementally change the mood from one of sorrow to one of recovery.

     Our experience: As we approached the funeral, the tone of our recorded telephone messages and the information posted on the intranet site began to change. We congratulated our crews for raising money for the families. We posted thank you notes from the families. We provided more information on the status of injured medic Sandra and how the company was assisting in her recovery. Over time, this approach empowered our employees to move beyond the tragedy without lingering feelings of guilt.

Summary
     In the event of a tragedy, a company should have separate crisis communications plans for the media, the families of any deceased, those who are injured and their families, and the workforce as a whole.

     We hope sharing our experience will help others plan for the crises that can occur in our industry. We all have operational plans for addressing the tragedies of others. What we learned at Southwest is that it's equally important to have crisis communications plans to address those tragedies that hit much closer to home.

Former IAFF Local I-60 President Gary August contributed to this article.

Josh Weiss is public information officer and director of corporate communications for Southwest Ambulance. He can be reached by phone at 480/655-7235 or via e-mail at jweiss@swambulance.com. Headquartered in Mesa, AZ, Southwest is one of the largest ambulance providers in the southwestern United States. In 2003, the service won EMS Magazine's annual Gold Award. A lasting tribute to Tammy Mundell, including TV news coverage from her funeral, appears on Southwest's website, www.swambulance.com.

Injured Medic: 'Our Hearts Can Grow'
     Sandy Williams is living proof that medics can pursue their passion even if they can't go into the field anymore. She describes what emergency personnel do as being "Who we are, not what we do. We do it on-duty, and we do it off-duty." Two years after surviving the horrific accident that killed her partner ("We were an awesome team," she says of her days with Tammy Mundell) and lying unconscious in the hospital for three weeks, Sandy's life is still filled with doctors and physical therapy.

     Thinking back on those hospital days, when people literally around the world were saying prayers, sending e-mails to her family and pulling for her recovery, Williams says, "I actually could feel the support. I don't know why, but you can just feel that the prayers are out there and everyone is pulling for you."

     She's back at Southwest Ambulance now, working full-time. The plucky paramedic returned to work as part of Southwest's community outreach programming, teaching people how to use AEDs. Today she serves as coordinator for the company's Project Heartbeat, a program that distributes AEDs throughout the community and teaches people how to use them. Sandy is also the new paramedic program coordinator, handling training. "If I can't do it, I'll teach other people to do what I love," she says. "I love what I'm doing. Southwest has been just awesome to me."

     While Sandy says she misses not being on an ambulance, she's happy. "Maybe we can't be where our hearts are," she reasons, "but our hearts can grow."