38 Creating patient death debrief sessions in the haematology & oncology department

<h3>Background</h3> Junior Doctors in the Haematology Oncology department expressed feeling unsupported after patient death on the ward, without adequate opportunity to process the event. Unexpected deaths and deaths of long-stay patients are not uncommon and can be emotionally difficult to process. <h3>Methods</h3> We sent a survey to junior doctors and physician associates asking how they could be better supported. Of 12 participants, only 33% managed their emotions around patient death well. 58.4% felt they received ‘not much support’, or were ‘completely unsupported’ after deaths at work. 91.7% agreed the department could do more to support them. The most popular suggestion for improvement was group debrief sessions. 100% of participants wished to involve the wider MDT. We started 15 minute debriefs during weekly oncology teaching, with the teaching consultant supporting discussions. This includes identifying recent deaths, reflecting, and discussing cases that individuals wish to process in more detail. Once a month the other 45 minutes of teaching is delivered by relevant teams such as Macmillan psychologists or Palliative Care to increase support. A debrief card was created, to enable any member of the MDT to easily facilitate the session. <h3>Results</h3> After implementing the sessions, another survey was created for feedback. 100% of responders felt the sessions were ‘very useful’ and rated support after deaths as now being ‘good’. People felt the card was easy to follow so anyone can lead. Improvement suggestions included longer sessions with more time for discussion. <h3>Conclusion</h3> Patient death on Oncology wards can have an emotional impact on staff, who require support to process their emotions. Regular team debrief sessions appear to be a useful way to provide staff with support after patient death. In future, we could make some of the sessions longer, to have more time to discuss more complex cases.