Lone dying in hospitals – Development of a student project: an interview with Carla Brooke, CNS

The following is an edited transcript of a conversation between Dr Marian Krawczyk and Carla Booke, CNS who is an MSc student in the End of the Life Studies Programme at the University of Glasgow and is currently conducting research for her final dissertation project.

You can find out more about her experiences in the programme HERE.

MK: Tell me a little bit about your background.

CB: I work in an acute hospital in the Southeast of England as a clinical nurse specialist in End-of-Life Care. I have been a registered nurse for 17 years. I began my career as a staff nurse on a breast and bowel surgical ward and worked my way to ward manager, managing different surgical wards in that time.

I then started a family and wanted a change in direction career-wise which is when I became a clinical nurse specialist in End-of-Life Care. I have worked in this role for 4 years. I work in a small team of 3 and we cover the hospital for all adult end-of-life care patients.

MK: What drew you to our End of Life Studies programme?

CB: I wanted to do some further education. Not only to improve my clinical skills; I wanted to think a bit more outside the box and think of ways that we can change practice in hospitals. In 2020 I completed the free 3-week End of Life Studies MOOC. I really enjoyed that and was able to put into practice what I had learnt. I approached my employer for education funding, and started the full MSc programme when it began in January, 2021.

MK: What have some of your experiences been like so far?

CB: I really like the interdisciplinary focus, all the different materials and assignments. It’s engaging and I like all the different styles of learning – the videos, the lectures, the seminars, the optional exercises, the expert interviews, among other things. Each of the six courses were interesting in their own way, sometimes quite different from each other, and I’ve learned a lot! I like the flexibility of the FutureLearn platform which allows me to be able to balance work, study, and being a mum.

MK: What is your final dissertation research project?

CB: I have witnessed a lot of death and dying in hospitals, and in my role I have witnessed it more than most. Throughout the Covid-19 pandemic, not only did the number of deaths in hospital increase but the circumstances in which people died in changed. When we covered lone and lonely dying in different parts of the world in the course material, and about the No One Dies Alone initiative as well as other ‘companionship schemes’, that made me want to do research in my own hospital and see if I could start something like that here.

I’ve now conducted an anonymous survey with almost 50 nurses in my hospital, asking if they think dying alone is an issue within their workplace, how often it happens, and what effect it has on them. Based on these findings I’m beginning to interview senior nurse staff about their own experiences with lone dying, challenges which increase the chance of patients dying alone, and their awareness and interest in companionship schemes. My goal is to improve end of life care in my hospital by gaining local knowledge and that my study will result in the development of a companionship scheme in my hospital. I also hope that other hospitals in my region find it useful.