Introduction

Overview

“I find families don’t really know what their expectations are; they have a fear of the inevitable”. – Canadian Paramedic
Overview
Uniting paramedicine and palliative care is an approach to care that recognizes the difference paramedics' skills can make at the most difficult time of life. Research has shown that when paramedics provide care and support to a person with an advanced illness, the experience of the patient and family is vastly improved. 

This shift in approach from the fast-paced emergency response to palliative care calls requires new clinical skills and tools in complex symptom management as well as an enhanced capacity in the "core clinical skills" of supporting the patient and family. Providing effective grief support to both patients and families is integral to providing high quality palliative care.  

These modules will provide you with a toolbox of strategies, skills, tips, techniques and best practices to guide you through the psychosocial aspects, the "core clinical skills," of palliative care calls. These core skills have been referred to as "the care that makes the difference." They address the grief families experience when someone they care about is dying and provide you with various tools to help you support the patient and the family during your palliative care call. You will also explore the grief experienced by paramedics in the course of their daily professional work, as well as some suggestions and practices to help you recognize and manage your stress and help you feel supported in your role. The modules were developed in collaboration with paramedics working in the field and are based on the latest research and clinical best practices. 

I've been there
Bonnie describes grief as an earthquake. (3:22)Video transcript

Every module presents a specific main tool in your toolbox and includes a variety of practical, hands-on ways to enhance skills, offering detailed examples and clinical techniques. This includes:
Conversation Prompts to help ask the difficult questions, speak to the family members during highly emotional moments or simply be supportive to the family and 
Reflective Points for your personal introspection and consideration in coping and processing the events that happen in your job and during the palliative care calls.


Click on each of the modules below to see a brief description.
  • Module 1, Palliative care, paramedics, and grief, explains the confluence of paramedicine, palliative care, and grief.
  • Module 2, Assessment and building trust, discusses the change in focus that paramedics need to bring to a palliative care call as compared to a typical emergency response. 
  • Module 3, Explaining clinical information and what to expect,  covers communication and how to explain common clinical issues to families. 
  • Module 4, Decision-making, explores how to collaboratively make decisions with families, as well as how to address any unrealistic expectations. 
  • Module 5, Challenging situations, addresses challenging clinical situations, including challenging relationships with families, traumatic deaths, pediatric situations, and Medical Assistance in Dying. 
  • Module 6, Supporting the patient and family, provides strategies for supporting families and handling difficult moments such as the time immediately before and after death. 
  • Module 7, Responding to the stresses of paramedicine, and Module 8, Opportunities for personal growth, support the paramedic with the inherent pressures that come with the job, suggesting useful ways to deal with work-related grief stress. 
  • Module 9, For families and friends of paramedics: Providing support, is for the families and friends of paramedics, and offers ways for these parties to care for the paramedic in their lives. 
We are grateful to all of the paramedics who have contributed to this series of modules to help guide their colleagues across the country through some of the most challenging and rewarding calls in paramedicine.

NOTE to learners:  

These modules have been developed to apply to students as well as paramedics with multiple years of experience. 

Throughout the modules, you’ll find suggested phrases to use in conversations with patients and families. Some of the language isn’t common to paramedic practice. Integrating this new language in palliative care calls will help you to establish relationships, have difficult conversations and provide support.