19 Caring through communication: strengthening compassionate communication in intensive care unit end of life conversations

<h3>Background</h3> Intensive Care Unit (ICU) practitioners that demonstrate good communication skills can positively influence family satisfaction with ICU care when a family member dies. Our Hospice was commissioned by a NHS trust to support their ICU staff improve their end of life care (EoLC) communication. Simulated EoLC communication skills workshops have positively impacted the confidence of doctors working in acute care settings but there is limited comparable education for ICU nurses. This project aimed to address this gap. <h3>Method</h3> Two sessions of a one-day workshop on EoLC communication skills were delivered to ICU nursing staff (registered and non-registered) in September/October 2024 by three specialist palliative care educators. The workshop included: didactic session introducing communication frameworks and video about communications skills small group simulated EoLC conversations between participants and simulated patient structured feedback using plus-delta model Participants reported pre and post confidence levels and qualitative feedback via a questionnaire. <h3>Results</h3> 26 nursing staff attended the workshops. Participants’ confidence increased in discussing the following: dying with a patient EoLC with family/friends of a seriously ill patient withdrawing ICU treatments with patients/families/friends 96% of participants rated the workshop 5 out of 5. Qualitative feedback demonstrated the importance of simulation: ‘the simulations were extremely helpful because … I got to do actual communication rather than just listening to a lecture on how to do it.’ <h3>Conclusion</h3> This workshop improved the confidence of participants in having EoLC discourse, enabling them to practice difficult conversations in a safe environment. This project demonstrates the positive role that hospices can play in providing specialist training to ICU staff in EoLC communication. We are now reviewing how to evaluate longitudinal effects on nurses’ confidence and exploring the impact of such skills on service users engaging with ICU nursing staff through EoLC.