The first paper to give voice to health and social care professionals providing end of life care during the COVID-19 pandemic has been published in Palliative Medicine, led by researchers at the Universities of Oxford, Liverpool and Sheffield.
The paper describes how providing end of life care during the pandemic has had a profound impact on health and social care professionals. They described struggling with the deaths of colleagues or their own family members and the risk of passing COVID-19 on to their loved-ones. Professionals had to take on the responsibility of being with patients in their final moments of life, as some families did not make it in time to ‘say goodbye.” The paper’s authors state that the long-term impact of these experiences for healthcare workers must not be overlooked.
The study makes important recommendations for health and social care services when providing end-of-life care during a pandemic:
- Clarity in government guidance is required about when relatives can visit a dying family member during a pandemic. Visiting should not be delayed until death is anticipated within hours—instead, end of life visits should be supported and encouraged when death is expected in weeks or days.
- Proactive access to structured psychological support should be promoted within clinical teams before and after a pandemic.
- Strategic leadership is essential to prioritize self-care for all members of staff, including time for clinical reflection.
- Where the redeployment of professionals is necessary, a ‘buddy system’ should be created between junior and senior clinicians.
- Charting daily communication with relatives will ensure families are kept up to date with their loved one’s condition and reduce their sense of dislocation at times of restricted visiting.
Adopting these recommendations is important as research shows that when psychological skills are taught and promoted within clinical teams, professionals report better job satisfaction, stress levels, general health, and productivity, with an overall reduction in burnout. Furthermore, relatives who are involved in the end of life experience report better psychological outcomes after bereavement.
Co-lead of the research study Dr. Stephen Mason, University of Liverpool, said: “Our data show the incredible lengths that health and social care professionals have gone to in supporting patients and their families. However, improved clarity in the operational and clinical governance of care is required to ensure practice is optimized and burdens for health and social care staff minimized as best possible.”
Lead author Dr. Jeff Hanna, University of Oxford, said: “The long term impact of the pandemic on frontline workers must not be underestimated. Visible leadership from senior staff is needed to facilitate opportunities for essential self-care. Although numbers of COVID patients have decreased, all NHS staff now face the enduring legacy of the pandemic on the wider healthcare system.”
Co-lead of the research study, Dr. Catriona Mayland, University of Sheffield, said: “The multiple emotional and practical challenges faced by health and social care professionals should not be taken lightly. Time for reflection and restoration of individual and team relationships is now vitally important.”
University of Liverpool