Dr Julia Jaensch1,2, Dr Naomi Katz2,3,4, Dr Alison Brown5
1Southern Adelaide Palliative Service, Adelaide, Australia, 2Peter MacCallum Cancer Centre, Melbourne, Australia, 3Alfred Health, Melbourne, Australia, 4Royal Children’s Hospital, Melbourne, Australia, 5Australian National University, Canberra, Australia
Biography:
Dr Julia Jaensch is a Palliative Medicine Fellow currently working with Southern Adelaide Palliative Service. She has a background in General Practice, and has trained across various sites in Victoria and South Australia.
Abstract:
Background:
Catastrophic events in palliative care occur infrequently but are distressing for all those involved, including nursing staff who are at the forefront of management.
Aim:
To explore the firsthand experiences of nurses caring for patients with a terminal illness who are at risk of, or have had, a catastrophic event, including the use of medications in this setting.
Methods:
A cross sectional survey of nurses with experience working with palliative care patients.
Setting/participants: Nursing staff working at a Comprehensive Cancer Centre in Melbourne, Victoria, members of Palliative Care Nurses Australia, and any nurses with palliative experience recruited via snowball sampling.
Results:
There were 79 responses to the survey. Nearly all respondents were familiar with catastrophic or crisis medication orders (69/74, 93%) and had cared for a patient with a prescribed order (69/74, 93%). More than half (41/74, 55%) had observed or administered a catastrophic medication order. Staying with the patient (68/70, 97%), supporting loved ones (65/70, 93%) and providing a calm environment (61/70, 87%) were almost universally identified as key aspects of management, surpassing medication administration (54/70, 77%). Nursing staff valued “pre-briefing”, debriefing, peer support and further training for catastrophic events.
Conclusions:
Nursing staff supported having prescribed crisis medication available. Planning for such events is important, taking into account the setting, staff availability and experience, and optional debriefing and/or peer support should be available in the aftermath. There is a role for further education and training of nursing staff to support their management of catastrophic events.