Journal of Clinical Sciences (Jan 2013)
Doctors′ experience and response to unexpected patient death in a Nigerian Teaching Hospital
Abstract
Background and Objective: Negative outcomes in patient care such as death can be an unpleasant experience not only for the affected relatives but also for the members of health care team involved in caring for the patients. If the death is unexpected, doctors are particularly affected as they often lead the health team and have had to make important decisions in the course of the patient care. The impact of such experience may be significant on the emotional well being of doctors′. This study aimed to determine the effects of unexpected death of patient on doctors in various specialties of a teaching hospital in Lagos. Methods: The study was cross-sectional and descriptive in nature. The subjects were specialist doctors or residents in training from 7 clinical departments in the Lagos University Teaching Hospital. Using a convenience sampling, a total of 143 doctors were included in this survey. All respondents completed a socio-demographic questionnaire which collected bio-data details, details of professional practice and experience related to patient death. Traumatic symptom recall was assessed using a Post Traumatic Stress Disorder (PTSD) Symptom Recall questionnaire. Results: Respondents were 143 in number, 56.6% from surgical specialties and 43.4% were of the non-surgical specialties. Over 95% were unaware of any institutional guidelines in place for directing how to handle challenges faced following patient loss. Over 94.4% admitted to loosing a patient suddenly before and about 69% had experienced such a loss in the past 1year. About half (58.7%) felt their performance was affected following sudden death of a patient. In exploring for retrospective recall experiences of symptoms following patients loss, 11(7.7%) of the doctors met the criteria suggestive of past PTSD symptoms. Almost half (43.4%) of the subjects desired any kind of support after patients death. Others expressed feelings of incompetence (25.9%), 56.6%, needed to use medication and 42% had appetite problems after the loss. There were no statistically significant differences between surgical and non-surgical specialties. Conclusion: There are mental health and emotional effects following unexpected patient death among doctors. Routes for support and institutional guidelines are encouraged in tertiary institutions of care. Such guidelines should be made available for doctors and other members of the health team.
