Abstract
[This is an excerpt.] Health and preventive interventions have significantly increased life expectancies in most developed countries. Resultantly, individuals are increasingly entering palliative care (PC) circumstances, and may present to the emergency department (ED) [1]. Providing care for individuals needing palliative services or at end-of-life (EOL) in the ED is challenging. Characterized by rapid assessment and initiating treatment with the goal of preserving life and facilitating recovery, the impetus within the ED is to ‘do something’ [[2], [3], [4]]. These goals can conflict with PC, which prioritizes ‘being with’ the patient; exploring goals with empathetic conversation while managing symptoms [3]. As such, the dying person can be ‘out of place’ and the dying process undermined by ED realities (e.g., crowding, time pressure) [5]. Exploring PC and EOL care in the ED is needed [6].Qualitative studies have begun to explore experiences of clinicians providing ED-based EOL care [1]. Across the literature, clinicians have identified ED space issues [[2], [7]], time pressures [[8], [9]], and inadequate PC education in pain management, as points of concern [[2], [7]]. Relational challenges were identified with some clinicians expressing fear of saying the wrong thing [2] and others intentionally distancing themselves [10]. A lack of pre-existing relationship exacerbated these challenges [7]. Additionally, ED staff face high risk of burnout in providing PC and EOL care within this acute care context [2]. [To read more, click View Resource.]
