47 Nursing views on providing end of life care on general medical and surgical wards

<h3>Introduction</h3> The National Audit of Care at the End of Life 2022 provided bereaved relative’s positive and negative views on inpatient end of life care. Views of non-specialist nurses regarding their ability to provide care has not been previously studied. <h3>Methods</h3> In Oxford University Hospitals Trust, short interviews of nurses from medical and surgical wards were conducted using open questions about confidence in caring for patients at the end of life and supporting their relatives, challenging areas and training needs. Results were analysed for frequency of themes by two separate reviewers. <h3>Results</h3> 32 interviews conducted across 10 wards, March 2024. Nurses often referred to the importance of providing good end of life care (EOLC), that they could understand the emotional distress of families and acknowledged the emotional impact on themselves in providing EOLC. Nurses reported more confidence in patient care (88%) and relatively less confidence in caring for relatives (53%). Nurses particularly reported communication with and managing emotions of relatives of dying patients as challenging (47%). Clinical pressures (25%), traumatic prior nursing experiences (16%), lack of plan or support from the medical team (13%) and rapid patient deterioration were reported as making providing good EOLC harder. Nurses reported wanting more training on assessment and treatment of symptoms (56%) and on communication skills (47%). Nurses asked for more clarity on practical aspects of management of patients and families eg. immediate post-death care, bereavement signposting. Nurses self-reported that both training in different cultural settings and having English as a second language were factors that increase challenges in caring for EOLC patients. <h3>Conclusions</h3> Little has been published on nursing views on providing end of life care. We are working with the specialist hospital palliative care team to create and tailor training interventions for non-specialist nurses to tackle the reported challenging areas.