A survey has revealed that over two-thirds of UK nurses (67%) feel that they don’t have sufficient time to provide high quality care for patients who are dying.
The survey, conducted by Nursing Standard and Marie Curie, asked nurses about their experiences of caring for patients who are in the final months, weeks and days of their lives. The survey was completed by 996 registered nurses and healthcare assistants from across the UK.
As well as not having enough time, other significant barriers to providing care to dying patients identified by the respondents were staffing levels (68%), lack of specialist palliative care support (33%) and lack of provision of community services (33%).
One of the hospital nurses commented: “Lack of staff, task-orientated wards, time constraints. That feels awful. I wish it was different.”
The survey also showed that the majority of nurses were aware of dying patients remaining unnecessarily in hospital as a result of delays in funding and community provision that would allow them to be cared for in the community. Over half (59%) of respondents said that they had ‘often’ seen or heard of this happening, while only 6% said they were not aware of any occurrences.
One of the nurses commented: “The biggest frustration in my job is not being able to get patients who are coming to the end of their lives out of hospital in time. I find it distressing and it is hard to switch off when I get home because it isn’t right.”
More than two-thirds (67%) of those surveyed said that their role involved caring for people at the end of their life. However, over 40% had not received any specific training in end of life care.
One of the residential care nurses commented: “Nurses find it hard particularly with less training to resist pressure to admit residents to hospital when crisis hits.”
Encouragingly, many nurses did express confidence in terms of being able to talk to patients about their needs and wishes towards the end of life. While several noted that it was a particularly challenging area of their work, over half (58%) said they were ‘fairly confident’ in having such discussions while a third (32%) said that they were ‘very confident’. Nurses said they were similarly confident in their discussions with families.
Dee Sissons, Director of Nursing at Marie Curie, said: “The findings show the challenges of providing high quality care to people towards the end of life in the extremely pressured NHS. Whilst it is encouraging to see that many nurses feel confident about talking to patients about their needs and wishes, we can’t dispute the evidence that the majority of nurses don’t feel that they have time to provide high quality care to their dying patients. It is also worrying to see that many dying patients with limited time left are stuck unnecessarily in hospital due to delays in funding and community provision to support them.
“Caring for people at the end of life can be emotionally draining but also incredibly rewarding. To provide the best possible care for patients, staff must have the time to develop their skills and access appropriate and timely training and support from the very start.”
Graham Scott, Editor for Nursing Standard, said: “The way we care for patients at the end of life is a barometer of the quality of care in the health sector as a whole. Nurses are telling us they are under immense strain and the service is reaching breaking point. The fact that vulnerable dying patients, and their families, are suffering as a result is a national disgrace.
“A first step towards addressing the problem must be to recruit more staff to free up nurses’ time so they can give the high quality care they so desperately want to give.”
Marie Curie has recently launched a free online resource for health and social care professionals which covers key aspects of palliative and end of life care. It includes topics, including; managing and alleviating symptoms, providing care for people with specific conditions, focusing on the needs of the individual and helping people during their final days.