End-of-life issues experienced by the nurse-led rapid response team: An analysis of extent and experiences

Abstract

ObjectivesTo examine the frequency, clinical characteristics and nurse-led rapid response team experiences of calls that involve end-of-life issues. Research methodology and designThe study consisted of two parts: 1) a retrospective journal audit of registered rapid response team calls for 2011–2019 that involved end-of-life issues, and 2) interviews with intensive care rapid response team nurses. The quantitative data were analysed with descriptive statistics and the qualitative data with content analysis. SettingThe study was conducted at a Danish university hospital. ResultsTwelve percent (269/2,319) of the rapid response team calls involved end-of-life issues. “No indication for intensive care therapy” and “Do not resuscitate” were the main medical end-of-life orders. The patients had a mean age of 80 years, and the main reason for the calls was a respiratory problem. Ten rapid response team nurses were interviewed, and four themes evolved from the analysis: “Uncertain roles for the rapid response team nurses”, “Solidarity with ward nurses”, “Lack of information” and “Timing of decision-making”. ConclusionTwelve percent of the rapid response team calls involved end-of-life issues. The main reason for these calls was a respiratory problem, and the rapid response team nurses often found their role uncertain and experienced lack of information and sub-optimal timing of decision-making. Implications for clinical practiceIntensive care nurses working in a rapid response team often face end-of-life issues during calls. Therefore, end-of-life care should be included in training for rapid response team nurses. Furthermore, advanced care planning is recommended to secure high-quality end-of-life care and to decrease uncertainty in acute medical situations.