1st Palliative Care and End-of-Life Decision-Making in Intensive Care Units Course – BASIC

It focused on the approach to patients admitted to intensive care with an adverse prognosis, who are dying in intensive care. Emphasis was placed on the process of decision-making about the appropriateness of care and on communication targeted at the patient and their beloved ones. The goal was to enhance participants' knowledge and skills in this challenging and often dreaded area of care. A major challenge and strength of the course was the planned involvement of both nurse and physician participants.

The course guarantors were MUDr. Jan Maláska, Ph.D., EDIC and doc. MUDr. MgA. Kateřina Rusinová, Ph.D. The lecturing team also consisted of experienced lecturers and clinicians, doc. PhDr. Alena Slezáčková, Ph.D., MUDr. Milan Kratochvíl, EDIC and Mgr. Jiřina Večeřová. The course is part of the work of the Research Initiative for Palliative Care and Ethics in ICU, the RIPE–ICU. The course is organized by the Institute of Simulation Medicine of the Faculty of Medicine, Department of Palliative Medicine of the 1st FM CU and VFN Praha and it is organised by the FM MU Institute of Simulation Medicine LF MU.

The introduction of the course was devoted to introducing the participants and sharing their motivations and experience. In the following three sessions, interactive teaching methods were involved and participants had the opportunity to practice identification of patients at the end of life and discuss the medico-ethical-legal framework under the guidance of the lecturers. Furthermore, they were taught systematic screening of basic needs of patients and their relatives in the form of a structured interview aimed at understanding and identifying patient's values and preferences. A separate session was devoted to linking medical alternatives and patient preferences in the concept of goals of care. Practice in shared decision making about appropriateness of care was followed by a lesson on communicating adverse news. In the afternoon, participants practiced practical limitation of organ support. At the end of the course, attention was also paid to the topic of coping with psychological stress and practicing techniques for increasing the mental resilience of health professionals in the context of the so-called self-care. The course also included a structured pre-learning session which participants received in advance of the course. It was evident that the preparation was very useful and they were able to get the most out of the course. A bonus of the course is the follow-up mentoring for all participants.

The interest in the course was enormous and the places limited, so not everyone could get there. Throughout the course, the shared energy of both lecturers and participants led to relationships being established, many of which will endure beyond the walls in which the course was held. The joy for us was mainly the satisfaction of the participants. The focus of the participants on a multidisciplinary team, i.e. doctors and nurses in one course, proved to be a very good choice. In conclusion, it remains to thank the RIPE-ICU team for the preparation of the course and the impeccable delivery, as well as for the support from the FM MU Simulation Centre. We look forward to seeing you! We are already planning to repeat the basic course and add an advanced one, too.