Soins palliatifs en unité de soins intensifs cardiologiques : réflexions d'équipe et propositions

A work on the development of palliative care was led within a Cardiac Intensive Care Unit (CICU). A questionnaire was distributed to professional careers in order to estimate the difficulties met during patients' care at the end of life. The situations lived as the most difficult by the nursing are: the obstinacy of a pain at the end of life, the suffering of families and the difficulties of communication with them, the sensation of therapeutic failure, treatments become unsuitable, and finally the lack of availability of the nursing for a good accompaniment. While the communication between the nursing is described as easy, that with the doctors of the CICU is considered insufficient. The communication with the patient and its circle of acquaintances is considered very difficult when diagnostic or therapeutic subjects are evoked. The main obstacles to a good quality palliative care are the lack of time, the lack of communication, an insufficient training and a inappropriate place. This reflection of development of palliative care within a CICU is innovative and must be encouraged. The training of the teams, the development of the communication so written as oral, the implementation by the cardiologists, assisted by experts in palliative care, of multidisciplinary meetings are simple means of improvement of the palliative care of the patients hospitalized in CICU.