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P1009: Heart sink encounters- emotional strain of end of life care for out-of-hours doctors

Nelson, Annmarie and Taubert, Mark ORCID: 2011. P1009: Heart sink encounters- emotional strain of end of life care for out-of-hours doctors. Presented at: 12th Congress of the European Association for Palliative Care, Lisbon, Portugal, 18-21 May 2011. Abstract Book of the 12th Congress of the EAPC. European Journal of Palliative Care: Hayward Medical Communications,

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Background: Palliative care in the out-of-hours period has been the focus of attention in many countries. The unpredictability of the clinical state of this sometimes frail patient group means that out-of-hours doctors may be confronted with many different end-of-life care situations. Patients in the out-of-hours period are seen by generalists who may not have any training in palliative care and the potential for stress from these sometimes emotional encounters to nonspecialists is not well researched. Objectives: We aimed to establish how prepared doctors who work regular out-of-hours shifts felt when dealing with end-of-life issues and palliative care patients and whether they felt they were emotionally equipped to do so. Methods: Semi-structured interviews were conducted with out-of-hours GPs. A detailed analysis of transcripts using Interpretative Phenomenological Analysis was undertaken. Results: A predominant theme expressed by GPs related to unease and even heart sink moments when having to deal with palliative care issues out-of-hours. ‘Heart sink’ in this context, referred to the subjective experience of the clinician. Emotional ‘housekeeping’, i.e. looking after one-self after emotionally charged encounters, was felt to be an important process and GPs used a range of coping mechanisms, including reflective time, sharing with peers, compartmentalisation and personal empathy to deal with stress. Conclusion: The emotional effects of palliative care encounters on out-of-hours general practitioners should not be underestimated. The isolated work pattern in UK out-of-hours services means that GPs are left to deal with problems alone. Pressed services may encourage a culture where discussion or debrief with a colleague after a palliative care encounter is not perceived as a practical option. This may contribute to work-related burnout in this group of doctors and out-of-hours services need to be aware of this issue, when planning for their services.

Item Type: Conference or Workshop Item (Poster)
Status: Published
Schools: Medicine
Publisher: Hayward Medical Communications
Last Modified: 09 Nov 2023 02:09

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