Jo undertook a PEPA placement with our Specialist Palliative Care Service in May 2022. The quality improvement activity that she undertook involved assisting to establish a small working group comprising several ED staff to progress and formalise an End-of-Life Care Plan which is cognisant of the care needs of patients nearing end-of-life and which considers the unique environment of a busy ED. So far progress has been made towards updating and streamlining an existing draft local policy on death and dying in ED, which includes reviewing medication protocols, symptom assessment and management, comfort care and supportive care for families.
The working group has also liaised with the inpatient palliative care team to better understand the variables associated with palliative care provision and patient/family wishes. Contextually, this considers what is available to patients and families should a palliative approach in ED situation (i.e anticipated death within 24 hours) change to an end-of-life approach and where transfer to ward/specialist palliative care unit/home is required.
Jo’s experience working alongside the nurses on the JW Whittle Palliative Care Unit has reinforced her desire to act as a workplace champion in supporting her colleagues with care provision to palliative patients presenting at all stages of their care trajectory. As part of her studies for a Graduate Diploma of Emergency Nursing, Jo undertook a literature review and critical analysis of the key issues in end-of-life care in the ED from a patient, family, and nursing perspective. Undertaking this literature review has informed her own practice greatly, and complements the learnings gained from her PEPA placement.