When 999 gets called at the end of life: equipping ambulance clinicians to promote a dignified death (hospices and ambulance service working together)

Abstract

Background End of life care is an emergent aspect of ambulance clinicians’ work. They are often called to an emergency or crisis in an individual’s last days of life and have to make complex decisions with limited information. However they receive limited formal palliative care education. Two hospices were approached by a local paramedic to see if they could help address this educational need. Aim of the Collaborative Work For ambulance clinicians to gain confidence in recognising end of life needs of patients and their families and delivering appropriate care. For hospice professionals to understand the role and abilities of ambulance clinicians in delivering end of life care. What have we achieved? Two hospices and their local Ambulance NHS Trust worked collaboratively to devise a one-day workshop for paramedics to explore palliative and end of life care. The workshop included communication skills, symptom control, recognising dying, promoting patient wishes and accessing local palliative care services. Feedback from 70+clinicians was good and their confidence scores increased ‘Helps make a grey area of our work more understood.’ Two paramedics completed the European Certificate in Essential Palliative Care and are recognised locally as palliative care champions within their work in the community and control room. Links established with local university; end of life care sessions delivered to third-year paramedic students and palliative care student placements arranged. Additional Benefits Increased mutual understanding of practitioners’ roles – informing practice and education. Paramedics accessing ongoing communication skills training. Paramedics delivering teaching to hospice staff highlighting end of life care challenges. Improved communication between ambulance crews and local hospices. Joint hospice and ambulance end of life care Facebook discussion delivered as part of the Ambulance’s service End of Life Care Awareness month Joint end of life care strategy working. https://spcare.bmj.com/content/bmjspcare/7/Suppl_2/A8.1.full.pdf This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/openhrt-2015-000281