Coping with death and dying on a neurology inpatient service

PUBMED ID:

22084123

PubMed - indexed for MEDLINE

Authors:

Khot S, Billings M, Owens D, Longstreth WT Jr

Institution:

Department of Neurology, University of Washington, 325 Ninth Ave, Box 359775, Seattle, WA 98104, USA. skhot@uw.edu

Title:

Coping with death and dying on a neurology inpatient service: death rounds as an educational initiative for residents

Source

Arch Neurol.2011 Nov;68(11):1395-7

Abstract

 

Background

Residents in neurology may feel unprepared to care for dying patients. We developed Death Rounds to provide emotional support and end-of-life care teaching for residents caring for dying patients on the inpatient neurology service. Death Rounds are monthly 1-hour clinical case discussions where residents identify issues through shared experiences.

Objective:

To survey neurology residents' perceptions of Death Rounds with respect to end-of-life care teaching and emotional support. Design, Setting, and

Participants:

We conducted an electronic survey of all (n = 26) neurology residents and recent residency graduates at the University of Washington 2 years after instituting monthly Death Rounds. Main Outcome Measure. The survey consisted of 10 questions examining residents' perceptions of the extent to which Death Rounds provided emotional support and end-of-life care teaching. We dichotomized responses to statements about Death Rounds as agree or disagree.

Results:

All 26 residents responded to the survey and attended at least 1 Death Rounds session. More than half of residents attended more than 3 sessions. Residents agreed that Death Rounds helped them cope with dying patients (17 residents [65%]), delivered closure for the team (16 residents [61%]), and provided emotional support, more for the team (18 residents [69%]) than the individual (10 residents [38%]). Most residents felt that Death Rounds provided useful teaching about end-of-life care (18 residents [69%]), and they were satisfied overall with Death Rounds (16 residents [61%]).

Conclusions:

Death Rounds afford an opportunity for physicians-in-training to process as a group their feelings, intense emotions, and insecurities while learning from the dying process. In our inpatient neurology service, most residents found it a rewarding and valuable experience.