Junior doctors “distressed” by patient deaths

Categories: Research.

Nearly all junior doctors quizzed for the study – 90 per cent – had experienced a patient death.

Over half had been disturbed by the death of a patient and had repeated disturbing memories of the incident as a result.

While more than half – 57 per cent – had experienced moderate to extreme distress.

The study undertaken at University Hospital Galway’s Department of Palliative Medicine.

The findings of the research – “Disturbing and Distressing – The Tasks and Dilemmas Associated with End of Life” – were presented at the 18th World Congress of the European Association of Palliative Care in Madrid, Spain.

Fifty three junior doctors with an average 28 months in clinical practice responded to a survey for the study.

The senior house officers – junior doctors – were asked  to record the number of times they had been involved in end-of-life tasks like pronouncing a death during their work.

A modified Post traumatic Stress Disorder checklist was then used to evaluate psychological distress following a patient death. Almost all of the doctors who responded to the survey had pronounced a death. The majority 88 per cent had discussed a patient at end-of-life with their families.

The study’s lead author, Dr Hannah Linane, palliative registrar at University Hospital Galway said: “We undertook this research to look at the difficulties that NCHDs encounter when managing patients at end of life and patients who have passed away. We looked specifically at medical, legal and cultural issues that pose difficulties and the impact that death and dying has on the Non Consultant Hospital Doctor.  

“We used a mixed methods approach, to include semi-structured interviews, to explore the difficulties experienced.  The data will inform the development of a postgraduate educational intervention and will serve to promote a culture in which these issues can be openly expressed and discussed.”

The research was undertaken following a 2016 report from the Medical Council which identified education gaps in communications skills, legal and ethical aspects and dilemmas around end-of-life care, in new entrant doctors to the health system.

Learning the specific knowledge, skills and attitudes to deal with end-of life issues is challenging and currently achieved by observation.

Most of the doctors had discussed the resuscitation status of a patient and 45 per cent had discussed withdrawal of care.

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