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49 A COVID-19 end-of-life multi-professional simulation course to prepare staff for difficult conversations with patients and relatives during the pandemic
  1. Sabrina Vitello,
  2. Sally Middleton,
  3. Eloise Van Vuren,
  4. Jessica Wadsworth and
  5. James Horn
  1. Epsom and St Helier University Hospitals NHS Trust


Background Most healthcare professionals redeployed to COVID-19 critical care or cohort wards in our hospitals in the first wave expressed feelings of discomfort and inexperience speaking about death and dying especially with relatives over the phone. Although doctors were initially expected to take on this role, as the first wave progressed, more nurses and Allied Healthcare Professionals (AHPs) recognised the need to speak with relatives themselves as they answered phones or doctors were unavailable.

Methods We designed and delivered a half-day multi-professional simulation course involving two scenarios: an in-person ward conversation with the patient and their relative, and a phone conversation with a relative ‒about clinical deterioration with COVID-19. One or two healthcare professionals were actively involved in each scenario while the rest of the group observed in another room. A whole group debrief followed. Interestingly, for the phone scenario, the cameras were set up so the observers could see both the healthcare professional’s and relative’s perspectives. Pre- and post-course surveys were completed by participants to evaluate the sessions.

Results 22 participants (doctors, nurses, AHPs and physician associates) attended across five sessions between 14th July and 11th November 2020. Pre and post-course scores showed increased confidence levels with discussing issues around death and dying including symptoms, psychosocial and spiritual needs with patients and relatives, especially over the phone. All staff recommended the course and felt scenarios were a good reflection of real-life situations. Qualitative data supported this and highlighted specific themes around preparation, phrases, non-verbal considerations for enhancing conversations. They also expressed the value of the multi-professional aspect of the course.

Conclusion There is need for more multi-professional courses encouraging junior doctors, nurses and AHPs to have conversations around death and dying. The half day duration of the course enabled both staff to be released from clinical duties to attend as participants and faculty.

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