Paramedics and their role in end-of-life care: perceptions and confidence

Abstract

Background: Studies have highlighted paramedics are inadequately prepared to care for patients who are at the end of their life, due to the historical focus of their training on acute medical management. This appears to cause conflict with paramedic perceptions of their role. Objective: To gain an understanding of paramedics' perceptions, confidence and concerns towards dealing with end of life care patients and their families. Design: An online survey comprising open and closed questions was distributed to all paramedics in a regional ambulance service in the north of England. Demographic data included: National Health Service (NHS) grade, personal experience, education and training to contextualise the data. A total population sample across differing organisational roles was used for paramedics in a regional ambulance service in the north of England. Responses were obtained from 182 staff. Results: NHS grade and length of service as a paramedic influenced the participant's confidence and concerns when dealing with end of life patients. A large number of participants (n=126, 70%) identified validity of documentation as a concern with 83 (46%) highlighting fear of litigation and 90 (50%) identifying that conflict with families was a concern. Support from other services was viewed as a contributing factor to increased paramedic involvement in end of life care. Conclusion: Most paramedics viewed end of life care as central to their role, but there was a need for further specific education to help enable paramedics to feel more confident, competent and supported in ensuring patients receive optimal care.