Our crucial journey in end-of-life care

A key part of being a health professional is to critically reflect on practice, whether as a paramedic, nurse, or indeed any other health profession. This skill is nurtured from the beginning of our training and helps us to critically think about and learn from our experience, in order to improve and enhance our practice, for the benefit of patient care. I have been reflecting back to when I started my undergraduate degree in 1999 and I realise there was little, if any, emphasis on end-of-life care, with no clearly defined learning objectives or opportunities in the curriculum. The mantra at the time, underpinning both ambulance and paramedic practice, was the three Ps: preserve life, prevent deterioration and promote recovery. All aspects of training and education were focused on the active treatment and recovery of patients with little consideration for end-of-life care.

Since the release of the Department of Health and Social Care's End of Life Care Strategy in 2008 and extensive subsequent research, much has changed and there has been a significant advancement towards the delivery of patient-centred end-of-life care, not just in the UK, but across the world. Despite this, as a society, we find it difficult to talk about death and dying, and this can also be said of health professionals. If we don't talk about it, how do we know what our patients' wishes are?