Teaching for our time

A frank conversation with Dr Mark Howard, Consultant at Saint Francis Hospice, Havering-atte-Bower, about what really goes on in a hospice. Things lots of people think but might not want to ask or say out loud. Valuable listening for all frontline staff as well as members of the public interested in finding out more about their local hospice. 

DNACPR conversations can be difficult. We discuss what makes them so challenging and potential pitfalls to avoid. There are some helpful phrases included too. What do you do when the patient disagrees with the decision? All this and more in a slightly longer than usual episode. More information available on the intranet under DNACPR.

A conversation focusing on the truth about Cardiopulmonary Resuscitation. Can patients or families request CPR when the professionals don’t think it will work? What is the law? What changed with the Tracey case in 2014?

A whistle stop tour of Advance Care Planning and Coordinate my care (the London wide online platform for recording care plans). What makes a good plan? Who should write them? Who can view them? How can you get help? Want more? Check out www.coordinatemycare.co.uk

Can we know when someone is in the last hours or days of life? In this episode we discuss some of the common signs, real life examples and the dilemma of numbers versus the overall clinical picture. More disease specific info here. 
 
 
 
 
 

A brief overview of the End of Life care plan used at BHRUT: discussion includes the origin of the plan, whiskey for mouth care, the role of intravenous fluids and what to do when someone gets better on the plan. More information can be found on the intranet in the Palliative Care Section or from our friendly End of Life care facilitators.

This session provides some tips for answering the really hard questions like “Am I dying?” or “How long have I got?” In the conversation we also consider how these questions make us feel and how that can impact our professional behaviour, should we or shouldn’t we use the ‘d’ word and how can we manage the uncertainty of prognosis honestly.

Covid has presented huge challenges to clinical staff communicating with patients and families. In this episode learn about some of the principles that underpin excellent communication, even through PPE or on the telephone. More information can be found on the BHRUT intranet under Palliative Care Covid guidelines and also on the Guidebook app.

In this 10 minute teaching session learn about using drugs safely to manage the symptom of difficulty in breathing. The conversation covers palliation at the end of life but also discusses whether the same drugs can be used for breathless patients who are not dying. Interesting fact we forgot to mention in the episode: 0.5mg of lorazepam is equivalent to 2.5mg of midazolam.

10 minutes teaching for you to listen to on the go. For this first episode, we cover how to manage breathlessness using non drug measures explained by Ben Seymour, specialist respiratory and critical care physio. Learn about Active Cycle of Breathing Techniques and how to position a breathless patient. More info at icusteps.org and yourcovidrecovery.nhs.uk