Reply To: Supporting Staff Caring for EOL/Dying Patients

  • Cara Johnson

    Member
    June 1, 2021 at 6:03 pm

    The questions I have:

    1) Describe your debriefing process after the death of a patient, more specifically whose death occurs in the hospital. Also, does debriefing happen every time? Who facilitates it? Does it happen every time? I guess that’s way more than just one question for question one…
    At this point in time we don’t do debriefings anymore. A majority of staff didn’t come and felt it was too formal. We do other gatherings like Popcorn Thursday/Friday and this helps the discussion more organically of complex situations….I think I already talked to you about this and we are still doing it 🙂 

    2) What support is available to staff at that time?N/A

    3) Is the support structure always enacted in the same way? For example, regardless if the patient has been there for 3 months or 3 days, are questions/actions the same?

    4) Describe any particular support given to the nurse/patient care tech who are caring for the patient during the time of their death.

    So we currently have been following a very specific algorithm that has done well since February. In that time we have had 11 deaths. 5 being on the unit and 6 at home. 
    We send cards to the staff that were on the care team and also the RN that took care of the patient if applicable. We told staff about the death and say who was on the care team so they can support each other. A manager will text each of the care team members and let them know when a patient passes. We also refer them to a Peer2Peer support program through the hospital. The nurse taking the patient usually is able to go home and if not we let them “take a walk” and give them a $5 card for the cafeteria. 
    Let me know if you want me to send you the algorithms 🙂 

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    Cara Johnson RNIII, BSN, CPON®
    Clinical Manager
    Hematology/Oncology Inpatient
    Cincinnati Childrens Hospital
    cara.johnson@cchmc.org
    Work: (513)803-0306
    Cell: (513) 490-9253
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    Original Message:
    Sent: 04-14-2021 05:08 AM
    From: Chris Donaghey
    Subject: Supporting Staff Caring for EOL/Dying Patients

    Team,

    There are no easy answers or perfect ways by which we can support one another through the sacred experience of caring for patients who are at the end of life and/or die during the shift we work. Our connections to some are inherently stronger than others; nevertheless, when someone dies on your shift, regardless of how expected it is, that’s extremely impactful.

    I’m reaching out to my APHON team everywhere to benchmark some practices, especially those you’ve established that are demonstrating appreciable value to your teams.

    We do have fantastic attendance at ELNEC training and that participation is supported structurally, though the ongoing skills and psycho-social-spiritual support post-ELNEC is scattershot.

    I think creating better structures within our team will not just benefit our PHO nurses, but potentially other teams across the hospital.

    The questions I have:

    1) Describe your debriefing process after the death of a patient, more specifically whose death occurs in the hospital. Also, does debriefing happen every time? Who facilitates it? Does it happen every time? I guess that’s way more than just one question for question one…

    2) What support is available to staff at that time?

    3) Is the support structure always enacted in the same way? For example, regardless if the patient has been there for 3 months or 3 days, are questions/actions the same?

    4) Describe any particular support given to the nurse/patient care tech who are caring for the patient during the time of their death.

    Thank you for your considered responses.

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    Chris Donaghey, MSN, RN, PCNS-BC, CPN, CPHON
    Clinical Nurse Specialist – Center for Pediatric Cancer and Blood Disorders
    Riley Hospital for Children at IU Health
    Indianapolis, IN
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