Workers ‘profoundly troubled’ over end-of-life care wishes

A third of nurses have been unable to fulfil their patients’ dying wishes because they do not have enough time, according to a survey.

Many healthcare workers are “profoundly troubled” by an inability to always care for end-of-life patients in the environment they would have wished, Dr Peter Carter, chief executive of the Royal College of Nursing (RCN) said.

The findings of the RCN survey, which had 7,721 responses, showed that just 10% of nurses felt they were always able to give the right level of care to their patients.

Other barriers to providing people with the right care are a lack of resources and training, the findings showed.

Almost 70% of respondents said they had seen cases where a person was taken to hospital against their wishes because the resources to care for them at home were not in place.

A quarter of people asked said they had not received training specific to caring for the dying, despite the fact more than half of nurses surveyed said they regularly treat people coming to the end of their lives.

Almost half of responses suggested nurses do not always have the chance to speak with patients about their preferences for their final days.

Dr Carter said the survey results have “touched a nerve” among nursing staff.

“Hundreds have told us about the honour and privilege of caring for people at the end of their lives.

“However, many are also profoundly troubled by their experiences of trying to deliver care for the dying, against a backdrop of staff shortages, lack of resources, inadequate training, cost pressures and rising demand.

“Sensitive nursing can make an enormous difference to the experience of a dying person and a “good death” with expert care can also make the bereavement process much easier for the loved ones they leave behind.

“Nursing the dying is an art, as well as a science. It cannot be reduced to a process of drug administration or a series of required nursing tasks, however important these things are.

“Nurses need time to listen to what the dying person wants, to recognise their fears and anxieties and to help loved ones to understand what is happening.

“The nation and the health service need to be better at acknowledging the importance of a good dying process, where our wishes about how we are cared for in our final days are respected and can be delivered when the time comes”.

He said the RCN will work to help support nurses to deliver the appropriate care, and called on the health service to ensure every dying person has the best end of life care possible.

Dr Ros Taylor, national director for hospice care at the charity Hospice UK, said the survey results are shocking and sad.

“We join the RCN in an urgent plea for more NHS investment in training and staffing to improve the experience of half a million people who spend their last days in hospital, to support the discharge of those who would prefer to be at home and to ensure more robust and confident round the clock care in the community,” she said.

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