It is our aim that health and social care professionals feel empowered to practice good palliative care with patients who they have supported through many aspects of their lives already.
a) ‘What to do’ – the head
The Gold Standards Framework is all about putting systems in place, taking a systematic approach to care. Symptom control is one of the seven C's, the key tasks of GSF. Symptom control seems complicated and a huge topic to cover. In reality there are about 15 conditions and modes of drug usage (‘Tripwires’), that form the core of symptom control. Historically they have been developed to help patients with cancer, but with slight modification, there is no reason for us not to apply the same approach when caring for non-cancer patients. If generalists could familiarise themselves with these ‘tripwires’ and understand when to seek further help, then not only would they feel empowered, but the impact on patient care would be immense.
The tripwires:
- Pain
- Nausea and vomiting
- Intestinal obstruction
- Breathlessness
- Cough
- Haemoptysis
- Respiratory tract secretions
- Spinal cord compression
- Superior vena cava obstruction
- Hypercalcaemia
- Management of the last few days of life
- Terminal restlessness and agitation
- Use of steroids
- Miscellaneous problems
- Indications for the use of a syringe driver in palliative care
b) ‘How to do it’ - the hands GSF has many practical tips and tools to help health and social care professionals ensure high quality care is provided. For symptom control use of assessment tools is strongly advocated but one specific tool is not recommended. Similarly Advance Care Planning is important and examples of tools are suggested. The decision about which to use is for individuals and local recommendation.
c) ‘Why’ we do it all - the heart. End of life care is about caring for the patient and their family and carers. With so many protocols and guidelines to follow and boxes to tick, the person to person caring at the heart of good end of life care is refreshing. There is a real passion for providing excellence, a real 'Gold Standard' of care at the end of life. Many professionals can share their personal experience of care shown to a relative or that watching a professional showing that deep level of care as being a driving force in their decision to work in a caring profession and a key part of their work that gives them satisfaction. Capturing the essence of this emotional drive in education is a real motivation to learn more about how to provide the best care.
All these areas are greatly assisted by using the Gold Standards Framework within your team. Working through the various levels, reflecting on your experiences of working as a team, providing a seamless service and learning from real cases is an amazing educational experience with the most important outcome, better patient care. Team and individual morale are also raised.
2 HOW to Learn
3 WHERE to Learn
