Picture the scene. An ambulance gets an emergency call. The paramedics arrive at the house to find that the patient may be approaching the end of life as a natural consequence of an illness. All the information they have to go on is what the patient and their family provide them. Should they take the patient to hospital?
For experienced end of life care professionals the answer might be obvious. For busy, time-challenged paramedics the decision might not be so cut and dry.
It’s that sort of scenario and a desire to support paramedics to make good, informed decisions for people at the end of life that has seen St Christopher’s join forces with London Ambulance Service (LAS).
In 2019 LAS paramedics and the St Christopher’s Community Nursing Team teamed up for training at a simulation centre where they mocked up a number of situations, role playing real life scenarios in which they might find themselves. The workshop was very well received and both organisations planned a follow-up event. Then came COVID-19.
“It’s about both teams working together to understand how we manage the important issues around end of life and learn together”Nigel Dodds, Community Nurse Consultant at St Christopher’s
Feeling well versed in online learning delivery, Nigel Dodds, our Community Nurse Consultant and Dr Emma Hall, Palliative Care Consultant, have organised a sequel and on 30 June, 30 learners – a mix of LAS paramedics and Community Nurses will log on for a two-hour workshop.
“It’s about both teams working together to understand how we manage the important issues around end of life and learn together, seeing it through each others’ eyes and understanding the challenges we both face,” said Nigel.
Nigel and Emma will be joined by colleagues Associate Clinical Practitioner, Caroline Phillips, and Senior Educationalist, Maaike Vandeweghe as well as three presenters from LAS.
The firm hope is that increased understanding will serve to further improve care for all people in South London at the end of life.
Nigel adds: “Over three to four years our relationship with LAS has improved significantly, thanks in part to the QELCA© programme training we’ve done together. They’ve now got their own end of life care team which can advise paramedics and, on a patient basis, we’ve seen an increase in referrals via LAS of people who traditionally would never have been referred to us. They are now working as our eyes and ears which is great.”
Meanwhile, Caroline, in her role can see the situation through a different set of eyes. She says: “As an experienced Paramedic I can say that there are several challenges surrounding end of life care when attending as an emergency response. There is often little information or prior knowledge known about the patient, and fundamentally, Paramedics are trained to recognise life threatening emergencies and rapidly convey people to the emergency department. Remaining in the community with patients who are complex and unwell is a big culture shift. It’s fantastic to be able to have this opportunity for joint learning, to learn from case examples, and gain a better understanding of others’ roles and how we can continue to work well together to provide joined-up care for those nearing the end of their lives.”
As well as role playing scenarios, attendees at the workshop will receive an update on Coordinate My Care and on the latest prognostication tools.