A Survey of Respiratory Therapist Preparedness for End-of-Life Care

Abstract

Background:

End of life care (EOL) is often a difficult time for medical professionals. Respiratory therapists (RTs) are often called upon to stop treatments or life support for patients who are near death. Like all professionals, RTs struggle with emotions in EOL. These issues are further magnified when the patient dying is a child. Most RTs have not had specific training in dealing with EOL issues and have entered EOL situations without any training. This has forced the RTs to encounter EOL situations ill prepared. The lack of preparation may add anxiety to an already tense and stressful situation1.

Methods:

The study was approved by the local IRB. Using an interpretive phenomenological approach, the research was conducted at a large pediatric hospital. RTs that were in clinical settings and were performing EOL were recruited by email. Interviews were conducted with 1/3 of the participants. The remainder of the participants submitted their answers using an online survey.

Results:

Online participants (N=39), 42% (15/39) cited ineffective hospital orientation about EOL and 44% (16/39) cited no hospital orientation about EOL. When asked about EOL training in RT school, 50% (18/39) responded with ineffective training and 36% (13/39) stated that they did not get any training in RT school. Regarding the interviews (N=13), there were 84% (11/13) female participants, 77% (9/13) had bachelor degrees and 77% (9/13) had NPS certification. All the participants (13/13) stated that they did not receive any EOL training in hospital orientation. With respect to EOL training in respiratory school, 15% (2/13) recalled receiving EOL training in respiratory school. Both participants are female. One is over 40 years old, has a bachelor's degree and less than 10 years of experience. The other is over 50 years old, has an associate's degree, NPS certification and over 20 years of experience.

Conclusions:

RTs are a required participant in all areas of this institution during EOL. However, they consistently lack structured training specifically in EOL. Based on the survey results from this institution, more training and discussion on EOL should be conducted in both RT schools and during hospital orientation. More research needs to be conducted specifically with RTs concerning EOL.

1. Brown-Saltzman K, Upadhya D, Larner L, Wenger N. An intervention to improve respiratory therapists' comfort with end-of-life care. Respir Care 2010;55(7):858-865.