Background Palliative and Intensive Care might seem like very unlikely co-operators in providing the best patient care, however, they are not as far apart as some think. Symptom burdens are high, not least because of the medical interventions, and these impact on the patient‘s care and sometimes outcomes. Psychological distress is high among both patients and relatives/carers. The burden is not only on patients (and relatives), but also on the staff of the ICU, not least because ‘palliative’ or end of life care may not be ‘what they came into ICU for’.
Methods We carried out an online questionnaire of ICU staff within our hospital. We wanted to get results from all employee groups, not just doctors. The questionnaire was a mixture of multiple-choice options and free text boxes. We plan to follow up on at least one of the groups identified with a more in-depth interview to ascertain their perceptions of palliative care.
Results Responses came from Cardiac, Neuro and General ICU as well as Surgical high dependency and were from a variety of staff: nurses (40%), doctors (20%), however also included HCAs, Physiotherapists, Ward Clerks and Pharmacists. The majority (83%) had experience of working with palliative care and had referred patients. The experiences of palliative care were overwhelmingly positive and highlighted the support to patients, relatives and also staff. 82% of responders felt that palliative care was well integrated into ICU. There was a wide range of views about who the palliative care team should see ranging from ‘any patient that has a diagnosis of progressive illness and requires support’, to ‘nurses and relatives’ to ‘those with symptom control issues’. Themes arising showed that the staff recognised the need for more relative and staff support.
Conclusions Palliative Care and ICU are well integrated in our tertiary hospital however there still remains more we could do and more the ICU teams would like in terms of support for the patients but also for relatives, and themselves as staff.
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