Projects

Dundee students reflect on their mortality

We know that many health care professionals find it difficult to talk about death and dying and experience anxiety when trying to approach the subject with patients and their families. Inappropriate euphemisms and misleading language are often used, which is a reflection of society in general. Within the University of Dundee, we are keen to support nursing students to develop knowledge and skills which will enable them to approach the topic of death and dying with patients and their families, with sensitivity and confidence.

During April and May 2014, the School of Nursing and Midwifery’s third year nursing students have been undertaking their final theoretical modules prior to registering as graduate nurses in the autumn. The modules they are undertaking include Managing Complex Care in the Community and Skills and Practice. Both modules include an in-depth focus on palliative and end of life care, loss, grief and bereavement. The students also take part in a clinical simulation exercise which involves students developing their communication skills, with simulated patients, focusing on conversations about death and dying.

Whilst we were aware that the Awareness Week is planned for 12-18th May, we really wanted to ‘spread the word’ and, therefore, took the opportunity to run a small event, alongside the students’ theoretical block, a little earlier than the national dates. We arranged ‘pop up’ “Before I Die Walls…” located in our University campuses and a link to a virtual wall for 4 days, coinciding with the week that palliative and end of life care was the main focus of the students’ taught sessions. Our aim was to encourage the students, in a positive way, to explore what was important to them and become more open to discussions around death and dying. We asked the students to reflect on how this may impact on their role as nurses and, by reflecting on the diversity of the students aspirations, explored issues of individuality and opportunities to enhance patients’ and family members’ experiences.

The “Before I die…” walls created a real ‘buzz’ around the University campus. Our tweets on Twitter were discussed, favoured and retweeted, there was media interest from local Radio (Radio Tay) and even an appearance on Scottish Television News for one of our students who was interviewed against the backdrop of our ‘walls.’ Interest spread as far afield as the Times Newspaper in London! As our photographs of the event testify, the students really engaged with the project and added many interesting aspirations to the walls.

We often use the materials and resources available from the Good Life, Good Death, and Good Grief and Dying Matters websites to supplement and support learning and teaching around death, dying and bereavement. We are already considering what other events we can hold to enhance the students’ learning experiences and raise awareness… perhaps a Death Café will be next?!

Lynn Griffin, Lecturer, School of Nursing and Midwifery, University of Dundee

Building on an Opportunity

Jen Wood, PR and Communications Manager, St Columba’s Hospice interviews Alison Allan about her project to build a Before I Die Wall in the construction site canteen of the new St Columba’s Hospice.

Alison Allan is currently completing her MSc in Palliative Care at St Columba’s Hospice, and has been working on this Health Promoting Palliative Care project as part of her academic work. The project involved promoting the topic of death and dying by encouraging construction workers building the new St Columba’s Hospice to write on the Before I Die Wall on the construction site.

What made you decide to choose this as the subject for your MSc dissertation?

I thought that building a new Hospice was a real opportunity to demystify what Hospices are about and that I wanted to set up a Health Promoting Palliative Care initiative to encourage our construction workers to think about this sensitive topic. St Columba’s Hospice is in the process of creating a brand new specialist palliative care facility on the same site as the original Hospice. Dying is a natural part of living and these construction workers are building a Hospice for people who are facing the end of their lives. I was conscious that many of those working on site were not as familiar with talking about death and dying as we are in healthcare and palliative care. I saw this as a possible opportunity for implementing a Health Promoting Palliative Care initiative as part of my work.

What is Health Promoting Palliative Care?

It’s about reminding people that dying is a natural part of living and encouraging people to become more open and confident in dealing with death and dying, in order that people and communities can provide more support for each other. It’s in everyone’s interests to talk about these subjects and to talk about the practicalities and emotions surrounding dying, while we have the opportunity.

Can you tell us a bit more about your project?

I am completing an MSc in Palliative Care and looking at Health Promoting Palliative Care as a topic. I was inspired by Good Life, Good Death, Good Grief Awareness Week to take action! The Before I Die project was already well established and I thought that it would work well on a building site. I was able to get funding from Good Life, Good Death, Good Grief, was supported by the Hospice, and had a Before I Die board produced. This board was installed in our construction site canteen and has now been in place from 13th May and will come down on Friday 16th August.

Has the board been a success with the site workers?

It’s been a great success! We intended to take it down at the end of Awareness Week, but I was asked if it could be left up as it was being well used and appreciated. There have been a wide variety of comments, many tongue-in-cheek ones which we expected, but also quite a few thoughtful ones.

How do you feel about this project in general?

I think it has worked well and has triggered some good questions and thoughtful responses, and interest in what Hospices do, as well as the usual humour which you sometimes find on building sites! I’ve been asked about death and dying and people have shared personal stories and have told me that they’ve found it helpful to be able to talk through some difficult subjects.

The board has now come down but it will be available for the Hospice to use in the future. I am planning a further initiative as part of my academic work before the end of the year.

Death awareness masterclass for occupational therapists

Pre-registration occupational therapy students on the BSc (Hons) programme at Queen Margaret University, Edinburgh will be offered the chance to participate in a ‘death awareness’ masterclass in November 2013.

This initiative stems from the work being done by one of the OT lecturers as part of an MSc in palliative care and will have a health promoting palliative care influence.

The students will take part in an experiential workshop examining the personal challenges brought by death and dying, with the aim of fostering resilience to cope with such issues in professional practice.

The students will develop an understanding of why it is important to talk about death and dying. They will have the opportunity to discuss different professional and personal perspectives on issues raised during the day.

An evaluation of the workshop will be disseminated – for further information please contact Joanna Beveridge.

Lothian Palliative Care Redesign Programme

Marie Curie Cancer Care is working in partnership with NHS Lothian and local partners to develop and deliver high quality palliative and end of life care and support, helping ensure people receive the care they want and need, in the place of their choice. The overall aim of the Redesign Programme is to assist in taking further the community-based model of end-of-life care currently in place across Lothian – maximising the time spent in people’s preferred place of care, minimising emergency admissions where these can be avoided, and supporting choice of place of death where this can be realistically achieved.

One of the four objectives of the Programme is “to raise public awareness of, and promote community involvement in death, dying and bereavement”. Key stakeholders from across NHS Lothian and Marie Curie took part in the workshop Health Promoting Palliative Care in Lothian – Options for Improvement in May 2013, at which delegates heard presentations relating to the theory and practice of health promoting palliative care. This included information about Good Life, Good Death, Good Grief and health promoting palliative care initiatives already underway in Lothian and elsewhere. Delegates then had the opportunity to contribute to the generation of a long list of options future potential health promoting palliative care initiatives for Lothian.

The list of ideas and solutions generated at the workshop has been collated, themed and grouped, and will be considered against the programme objectives and a number of “critical success factors” set by the Programme Board. It is envisaged that the Outline Business Case for the programme as whole – setting out the preferred options across all the workstreams, will be approved by January 2014 at which point detailed planning and phased implementation of the of the resulting projects will commence.