When resuscitation doesn't work: A qualitative study examining ambulance personnel preparation and support for termination of resuscitation and patient death.
Attitude to death
Death
Education
Emergency medical services
Medical futility
Out-of-hospital cardiac arrest
Paramedics
Resuscitation decisions
Journal
International emergency nursing
ISSN: 1878-013X
Titre abrégé: Int Emerg Nurs
Pays: England
ID NLM: 101472191
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
12
12
2018
revised:
01
10
2019
accepted:
29
11
2019
pubmed:
13
2
2020
medline:
23
3
2021
entrez:
13
2
2020
Statut:
ppublish
Résumé
Many ambulance personnel can withhold or terminate resuscitation on-scene, but these decisions are emotionally, ethically and cognitively challenging. Although there is a wealth of research examining training and performance of life-saving resuscitation efforts, there is little published research examining how ambulance personnel are prepared and supported for situations where resuscitation is unsuccessful, unwanted or unwarranted. To identify and describe existing preparation and support mechanisms for ambulance personnel enacting decisions to terminate resuscitation and manage patient death in the field. Focus groups were held with senior ambulance personnel working in clinical education and peer support roles. Participants believed professional and personal exposure to death and dying and positive social modelling by mentors were essential preparation for ambulance personnel terminating resuscitation and managing patient death. Ambulance personnel responded to patient death idiosyncratically. Key supports included on-scene or phone back-up during the event and informal peer and managerial support after the event. Clinical and life experience is highly-valued by ambulance personnel who provide training and support. However, novice ambulance personnel may benefit from greater awareness and rehearsal of skills associated with terminating resuscitation and managing the scene of a patient death. Organisations need to acknowledge idiosyncratic staff needs and offer a variety of support mechanisms both during and after the event.
Sections du résumé
BACKGROUND
Many ambulance personnel can withhold or terminate resuscitation on-scene, but these decisions are emotionally, ethically and cognitively challenging. Although there is a wealth of research examining training and performance of life-saving resuscitation efforts, there is little published research examining how ambulance personnel are prepared and supported for situations where resuscitation is unsuccessful, unwanted or unwarranted.
AIM
To identify and describe existing preparation and support mechanisms for ambulance personnel enacting decisions to terminate resuscitation and manage patient death in the field.
METHOD
Focus groups were held with senior ambulance personnel working in clinical education and peer support roles.
RESULTS
Participants believed professional and personal exposure to death and dying and positive social modelling by mentors were essential preparation for ambulance personnel terminating resuscitation and managing patient death. Ambulance personnel responded to patient death idiosyncratically. Key supports included on-scene or phone back-up during the event and informal peer and managerial support after the event.
CONCLUSION
Clinical and life experience is highly-valued by ambulance personnel who provide training and support. However, novice ambulance personnel may benefit from greater awareness and rehearsal of skills associated with terminating resuscitation and managing the scene of a patient death. Organisations need to acknowledge idiosyncratic staff needs and offer a variety of support mechanisms both during and after the event.
Identifiants
pubmed: 32046949
pii: S1755-599X(19)30118-1
doi: 10.1016/j.ienj.2019.100827
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100827Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.