Ann Corbett & Jodie Morris Clinical Nurse Facilitators End of Life Care SUPPORTING THE SUPPORT WORKERS

Our initial motivation… Health Care Assistants -  Provide the majority of day-to-day care for patients  Are the predominant bedside nurses  Are visible / available to relatives and carers  Are often regarded as indispensable  Have little if any opportunities to access communication training

Why we did it…  EOL Care strategy (2008) emphasised the importance of communication training at all levels  Feedback from education sessions highlighted that HCAs lacked confidence in difficult communication  EOL complaints

How we approached it …  Training needs analysis (TNA)  Undertook advanced communication training  Included the help of a counsellor  Formulated a teaching plan  Designed an application form  Devised pre and post evaluation tools

What we did…  Based on the “Connected” advanced communication course we -  Devised a two day course  Employed actors  Used filmed interactive role play  Applied constructive feedback  Utilized communication exercises

What we learnt…  HCAs are keen and enthusiastic  They feel under valued  Increased confidence - from pre and post questionnaires  There is a need for communication training for HCAs  Role play and constructive feedback was invaluable

From the evaluations …  The participants reported increased confidence by at least 70% in –  discussing EOL care with relatives / carers  discussing EOL care with patients  discussing death / dying with relatives  challenging behaviour of relatives

On Reflection…  Slight restructure  Accommodate maximum learning experience  Decreased group size to 8  Extend exposure to different scenarios  Improve group dynamics  Compounding relationships (feeling safe)

Where do we go from here ?...  Run 4 courses a year as part of ongoing training in EOL care  Enabling 32 HCAs to be trained over a one year period  Apply for the course to become accredited  Secure ongoing funding  Extend the training to include all staff exposed to EOL care

References DOH (2008) End of life Care Strategy Levinson et al (1997) Physician - Patient communication