Care and Support of Respiratory Staff Caring for End-of-Life Patients

Abstract

Background: End of life care is difficult for all medical professionals, causing struggles with grief during and after the death. Very few respiratory therapists (RTs) perceive they are prepared to assist the dying process. These same RTs have to remove life support or stop life sustaining therapy. The objective of this project was to determine if a compassionate care RT support team trained with knowledge of end-of-life practices, brain death testing, religious and cultural requirements, and organ donation process including ventilator management would be a perceived benefit to our staff.

Methods: A compassionate care RT team was formed in April 2019. Staff were trained using End of Life Nursing Education Training Course (ELNEC), Life-sharing lectures, simulation lab scenario training, and lectures on spiritual, religious, and cultural aspects of end-of-life care. 16 months after training and implementation of the team, a convenience sample of 120 pediatric RTs were provided the opportunity to complete an online survey about end-of-life help. Participants were asked five questions, but each question was optional.

Results: Voluntary online participants (N = 48), of the survey respondents, respiratory staff each cared for between 1–20 (mean 2.79) end of life patients between July 1, 2019 and June 30, 2020. Of these, 77.1% (37/48) would consult the compassionate care RT team as a resource for end-of-life care, and of those who would not call the team 22.9% (11/48) commented they felt they did not think they needed it, had been in the field a long time, or felt they would use other resources such as social worker, charge nurse, or respiratory director. 68.2% (30/48) knew the names of all the staff on the team. 95.8% (46/48) felt that having a compassionate care RT end of life team is beneficial to our staff. 4.2% (2/48) stated no benefit, but added the comment perhaps to newer therapists. When asked what the team could do better most 52% (25/48) stated there needed to be more team members on night shift, and 25% requested a better way to know whom to call on their shift if they have an end-of-life patient.

Conclusions: Implementation of an end-of-life compassionate care RT team has been beneficial to our staff who feel comfortable calling them as a resource, and know the names of the staff on our team. Additional needs were identified for more night shift resources and improvement of communication during the shift if an end-of-life situation arose quickly.