Oral Presentation Palliative Care Nurses Australia Conference 2020

‘There will be times when priorities compete’ Caring for people who die suddenly and unexpectedly in the emergency department: nurses’ experiences. (70334)

Katrina Breaden 1 , Tracey Giles 2 , Karen Hammad 3 , Christine Drummond 4 , Sandra Bradley 5 , Adam Gerace 6 , Eimear Muir-Cochrane 1
  1. Flinders University, Adelaide, SA, Australia
  2. Independent consultant, Adelaide, South Australia, Australia
  3. Independent consultant, Adelaide, South Australia, Australia
  4. Central Adelaide Palliative Service, Adelaide, South Australia, Australia
  5. Flinders University, Adelaide, SA, Australia
  6. CQ University, Adelaide, South Australia, Australia

Introduction

The number of people presenting and dying in the ED is increasing and more will do so as our Australian population ages. Emergency departments (ED) are usually not designed or equipped for compassionate end of life care encounters, especially when the death is sudden or unexpected.

Aims

The aim of the study was to investigate nurses’ perceptions and experiences of caring for people who die suddenly and unexpectedly whilst in the ED.

Methods

Thematic analysis of open-ended responses to an online survey was undertaken. A total of 211 nurses responded to the survey

Results

Five themes were identified in the nurses’ responses; Key elements of end of life care, systemic and environmental barriers, educational deficits, role ambiguity and the emotional impact.

Discussion/Implications for practice

The nurses who responded to the survey believed that improved communication and targeted education, and a whole of system approach to end of life care, supported by policies and guidelines, was needed to effectively care for people who die in the ED. In addition, end of life care needs to be re branded as ‘urgent’ care so that is does not become an afterthought in a chaotic environment.

Conclusion

Even though ED nurses want to provide safe and compassionate end of life care in the ED, they are often prevented from doing so by multiple factors outside their control. There is a cultural and attitudinal change needed in this complex and fast-paced environment to overcome the challenges identified in this study.