References
Attitudes and perceptions of paramedics about end-of-life care: a literature review
Abstract
Background:
Paramedics must be prepared to respond to crises in which a threat to a patient's health may result in death. They are therefore highly involved with end-of-life care.
Aims:
Involvement with end-of-life care is the context in which this paper examines how paramedics perceive and respond to this part of their role.
Methods:
This is a systematic literature review that examines current evidence.
Findings:
Five themes emerged, which suggest that paramedics are not prepared to work with crisis situations involving the end of patients' lives: emotional resilience; decision making; communicating death; recognising dying patients; and death education.
Conclusion:
The current review concludes that the dearth of data is not preventing improvements in services, nor education and training, in this field.
End-of-life care is not unidimensional, nor is it delivered in a single setting. The context in which care towards the end of life is offered varies widely, both nationally and internationally. Emergency care is one such context in which professionals often offer services that respond to needs related to the end of life, whether they concern grief, bereavement or an imminent death. Therefore, paramedic practice is important in the provision of end-of-life care, especially when individuals are faced with an unexpected crisis. Brady (2013a; 2016) and Pettifer (2011) opine that paramedics play an important part in end-of-life care; however, they are often inadequately prepared because their training has historically focused on acute medical management and includes limited palliative care education (Kirk et al, 2017). The Social Care Institute for Excellence (2013) highlights that paramedics are often not made aware of end-of-life care priorities, choices and advanced decisions on refusing resuscitation. According to Lord et al (2012), this may create feelings of conflict in paramedics over their perception of their role, which can lead to professional uncertainties.
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