Background
Negotiating goals of care with patients is an essential skill for all health professionals in hospitals. End-of-Life Essentials (EOLE) is a Commonwealth funded project that delivers peer-reviewed, evidence-based, online education and practice change resources. To date, around 25,000 doctors, nurses and allied health professionals have registered to access the education. ‘Planning End-of-Life Care - Goals of Care’ features in the suite of EOLE modules and includes education around negotiating goals of care with patients and families.
Aim
To explore the views of module learners (health care professionals) on challenges they have faced around negotiating goals of care with patients and families.
Methods
Participants were health care professionals who engaged with the EOLE Goals of Care module. Responses to a question posed at the end of the module ‘What are the hardest or most challenging things about negotiating goals of care with patients and families?’ were extracted for a 12-month period. Qualitative data from 451 health care professionals were thematically analysed in NVivo 12, using an open, inductive approach to privilege participants’ voices.
Results
This paper will discuss the main thematic results of this analysis including managing emotions, aligning the needs, views, and values of the patient with those of the family and health professionals, finding a middle ground, managing expectations, initiating end-of-life conversations, acceptance of death, and navigating conflict when it arises.
Implications for Practice
Most Australians want the opportunity to discuss and plan for the end of their life and we know that this is not happening enough in hospitals. Initiating conversations about end of life can trigger emotions. In practice, differences of opinion will arise, and having a strategy to manage conflict is essential. The findings from this paper will provide learnings from health professionals on the challenges to effectively negotiating goals of care with patients and families.
Conclusion
Planning end of life care in line with the patient and family wishes is essential for quality care, however there are many challenges to this in practice. This paper will provide insight around some of the biggest challenges faced by health professionals and discuss ways to overcome them.