The British Medical Association has called for more support for doctors caring for dying patients after a survey found fewer than one in five physicians feel they get sufficient assistance.
The poll highlighted the deep-seated effect that treating patients at the end of their life has on doctors, with 93.9% saying it has an emotional impact on them.
Dr Zoe Greaves, the BMA’s medical ethics committee deputy chair, said: “Although doctors are professionally trained to deal with death, the emotional toll from caring for patients at the end of their life should not be underestimated. Doctors will always remember their ‘first death’ and for many there are those more difficult cases that always stay with you.”
She said the BMA wanted to see the use of support services become normal practice, with staff encouraged to access them early “before their health is adversely affected”.
More than a third (37.2%) of the 457 doctors who responded to the online poll said they cared for dying patients frequently or all the time. A similar proportion (34.6%) said they occasionally cared for people at the end of their life, with 28.2% saying they never did.
Only 14.7% said they had accessed formal or informal support networks, either locally or nationally.
One respondent wrote: “I don’t think we spend time thinking about the emotional impact, so we bottle it up then burn out.”
Another said: “Just get on with it. There is no support.”
Others said colleagues were their only outlet to talk through their experiences in the absence of other assistance. “Essentially [I] have no support, other than discussing with colleagues (medical and nursing) informally,” one said.
But another said they did not even have that option, saying most medics assume “I should be able to cope”.
Where doctors had accessed support services offered by specialist palliative care units or staff, the response was positive, with 92% saying it met their needs.
One doctor, who did not want to be named, told the Guardian that in her first year on the job she was left alone to deal with a patient at the end of their life as the senior doctor was in theatre.
She said that earlier that day the patient’s family had been given test results that suggested the patient would survive a little longer and so their rapid deterioration was unexpected and left the family completely unprepared.
“I felt completely helpless, but knew I had a duty of care to that patient to make their death as good as possible,” she said.
“When the patient did pass away, I verified the death, knowing what I needed to do, but with no support. I was compassionate with the family who were crying and wailing – that’s the one thing I knew I could do. I felt upset afterwards. No one debriefed me, and that was that. Later, the family brought me a touching thank you card – I was very surprised as I felt it was extremely undeserved.
“As doctors we deal with death frequently, but it doesn’t make it any easier. You are very aware that those moments stay with the relatives and loved ones for the rest of their lives, so it is vital we have the support, time and training necessary to get it right.”
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