Format

Send to

Choose Destination
Respir Care. 2016 Jul;61(7):891-6. doi: 10.4187/respcare.04168. Epub 2016 Jun 7.

Respiratory Therapists' Experiences and Attitudes Regarding Terminal Extubations and End-of-Life Care.

Author information

1
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia. Emory Palliative Care Center, Emory University, Atlanta, Georgia. anjali.grandhige@emory.edu.
2
Department of Respiratory Care, Emory University Hospital, Atlanta, Georgia.
3
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia. Emory Palliative Care Center, Emory University, Atlanta, Georgia.
4
Emory Palliative Care Center, Emory University, Atlanta, Georgia. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
5
Emory Palliative Care Center, Emory University, Atlanta, Georgia. United States Department of Veterans Affairs Medical Center and Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia.

Abstract

BACKGROUND:

Respiratory therapists (RTs) routinely care for patients with life-limiting illnesses and in some hospitals are responsible for terminal extubations. Data on how such experiences affect RTs are scarce. The objective of this work was to survey RTs at 2 academic medical centers about their experiences caring for patients with terminal extubations.

METHODS:

An online survey was distributed to the hospitals' RTs. Survey data included demographics and experiences with end-of-life care and terminal extubations. The survey was derived from previously published questionnaires plus input from hospital RT leaders.

RESULTS:

Sixty-five of 173 RTs (37.6%) responded. Of these, 42.4% were ≥50 y old, and 62.7% were female. 20.3% had ≤5 y experience; 52.5% had ≥16 y. 93.8% self-reported being involved in at least one terminal extubation; of those, 36.1% reported performing ≥20. Nearly half (47.5%) wanted to be involved in family meetings discussing terminal extubations, but just 6.6% were frequently involved. Only 32.3% felt that they received adequate education regarding terminal illness in RT school; 32.3% reported gathering this knowledge while working. 60.0% wanted more formal education around terminal patient care. 27.9% reported sometimes being uncomfortable with performing a terminal extubation; most of these rarely felt that they had the option not to perform the extubation.

CONCLUSIONS:

RTs are rarely involved in end-of-life discussions despite a desire to be, and they experience situations that generate discomfort. There is demand for more formal RT training around care for terminal patients. Clinical protocols that involve RTs in meetings before ventilator withdrawal should be considered.

KEYWORDS:

end of life; palliative care; respiratory therapist; ventilator

PMID:
27274094
DOI:
10.4187/respcare.04168
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center