(368) Healthcare Professionals’ Experiences in Providing End-of-Life Care and Bereavement Support

Introduction: Caring for dying patients and their families is common in the intensive care unit (ICU), step-down unit (SDU), and emergency department (ED). Because of this, incorporating high quality end-of-life (EOL) and bereavement care is strongly supported by critical care organizations to help support families. However, follow-up with bereaved families is limited and there are no set standards on what should be provided to bereaved families in these high acuity units. Therefore, the aim of this study was to qualitatively describe HCPs’ experiences providing EOL care and bereavement support in the ICU, SDU, and ED.

Methods: Using an exploratory, qualitative design, we interviewed physicians, social workers (SWs), and registered nurses (RNs) who worked in either the ICU, SDU, or ED from a large community hospital to understand their experiences in providing EOL care and bereavement support. We conducted interviews via a secure, HIPAA compliant web-based platform. The interviews were facilitated by the study investigators using a semi-structured interview guide. All interviews were recorded and transcribed verbatim. Data was coded independently by the study investigators using NVivo software and analysis was concluded when consensus on themes was achieved.

Results: We interviewed nine HCPs: six RNs, two SWs, and one physician. The majority were female (66.7%), from the ICU (66.7%), with a mean age (SD) 41.3 + 7.1 and work experience ranging from six months to 25 years. Five main themes about HCPs’ experiences with providing EOL care and bereavement support emerged: (1) spirit of teamwork and collaboration; (2) EOL care and bereavement support was focused mainly on the families and occurred during the hospital stay; (3) being human and the emotional impact of providing this type of care; (4) mixed feelings on providing bereavement follow-up with the family after the hospital experience; and (5) the need for EOL care and bereavement support training.

Conclusions: This study provided insight into the experiences of HCPs working in high acuity units in providing EOL care and bereavement support. Having a better understanding of who provides this type of care, what type of care they provide, and what type of training is needed may help improve and extend the care provided to grieving families.