Background Previous research has found that palliative care staff find it distressing when patients with whom they have grown close die. Hospice staff at units serving geographically remote populations are likely to provide palliative care frequently for friends, family and colleagues.

Aims This mixed methods study was designed to (i) determine whether levels of burnout were higher in hospice staff who had provided care for a greater number of people they knew personally and (ii) explore professionals’ experiences of providing this care.

Methods Fifty nine participants from two hospice units completed the Maslach Burnout Inventory and reported the number of patients they had cared for over the last year who were friends, family or colleagues. They also reported stressors they perceived as causing and protecting against burnout. Eight participants then took part in focus groups to explore their experiences of providing palliative care for people they knew personally.

Results >75% of participants had provided care for people they knew personally in the last year (Mean=4.4). Burnout scores were low and there was no relationship between burnout and the number of patients staff had known personally over the last year. While participants reported stressful aspects of caring for people they knew, particularly pressure to ‘get it right’, time pressures and team conflict were more consistently implicated in burnout. Factors such as sense of privilege, self-care, and support from colleagues acted as a buffer against burnout.

Conclusions Levels of burnout in staff providing end of life care are low. Where burnout does occur, it is more likely to be caused by organisational issues rather than any aspect of caring for patients. The emotional toll and pressure of providing palliative care to family, friends and colleagues is mitigated by a range of protective factors. By drawing on coping strategies, this is often an intensely rewarding experience.

Acknowledgement This study was funded by the Isle of Man Research Committee.