End-of-life care in acute care hospital

A post written by Jeanette Lacey

There is no doubt that the last 3 years in our acute care sector has changed us. COVID-19 tested and continues to test us in many ways. We have on one hand learnt about the resilience and dedication of health care professionals, and on the other hand systems that were already overburdened reach crisis point. As an End-of-Life Care Nurse Practitioner I have been at the frontline of dying in my hospital, for over 7 years, and the last 3 years have been some of the most challenging. The pandemic is not over and still affects us on a daily basis, whether it be patients, staff on sick leave, staff leaving the profession, today loss of critical supplies and medications continues to challenge us.

What happened in our acute care hospitals in the last 3 years?

We watched people die without their loved ones. Some families wanted to be there, some families felt too frightened to be in that space, and some families were stuck at home nursing their own COVID infection. Families who for many years had been looking after their people at home, suddenly found themselves without the services to help. People who wanted to die at home got COVID and became more unwell, they found themselves in hospital isolated and alone. Some of them didn’t get COVID but couldn’t get the symptom relief they needed in the community and were forced into our facilities for help.  

We found people during this time, too scared to get that “new lump” checked out by their GP. Primary health care found themselves overwhelmed by fear, sickness, and government expectations.  Now we find people presenting with advanced illness, still scared to enter our facilities in case they “catch something”. 

I felt privileged and proud to work in a hospital that recognised that we have one chance to get this right and tried where possible to have at least one loved one by the bedside of the dying. When we had families that couldn’t be present, many of our bedside nurses and I sat with the dying, so they wouldn’t be alone. We saw staff embrace the use of technology and telehealth, even when it was difficult and hard to get it right- so that families could see each other (whether they were dying or not). We supported and communicated with families who didn’t know whether they would ever see their loved one alive again after they entered our buildings. The people were terrified and we were too. This was our COVID-19 experience, but in any year half of all deaths in Australia occur in hospitals. The pandemic has reminded us that knowing how to support people at the end of life is also part of our role.

Jeanette Lacey
End-of-Life Care Nurse Practitioner
Hunter New England LHD