Career advice

Providing care throughout end of life, into bereavement and beyond

The Swan model of care offers comprehensive support at every stage, writes Fiona Murphy 

The Swan model of care offers comprehensive support at every stage, writes Fiona Murphy 


Logo of the Swan model of end of life and bereavement care 

In most NHS organisations, end of life support is offered to patients, their families and significant others of those expected to die. But offering bereavement support to families of patients who die suddenly or unexpectedly is a challenge, one that many care settings do not meet.

This is why the Swan model of end of life and bereavement care was created. Instigated at the point of recognition of dying, the model (see box below) is used to support care throughout end of life, into bereavement and beyond.

Launched at Salford Royal NHS Foundation Trust in 2012 when I was its assistant director of nursing, the scheme is now in place in more than 50 trusts in England.


Fiona Murphy (second from right) with colleagues at the launch of the Swan model
at the Pennine Acute Hospitals NHS Trust in February 2017.

Individualised care 

The initiative aims to promote dignity, respect and compassion at the end of life, and provide excellent, individualised end of life and bereavement care for every patient and every family, every time.

A swan sign is placed on the door or curtain of the area in which the dying person is being cared for. Staff inform the family wherever possible of what the Swan model means, and where the swan sign is displayed, relatives can have open visiting around the clock.

The sign also acts as a visual reminder for all staff to employ the principles of the Swan model in their care for that person and their loved ones, and reminds everyone, including other visitors, to be mindful of maintaining as peaceful an environment as possible.

Making informed decisions

End of life is a difficult time for patients and relatives, with many choices available to them. The Swan scheme gives them the help they need to understand these choices, such as whether to sign the organ donor register and whether they would prefer to die at home.

Relatives are given ‘memory bags’ for deceased patients’ property, and are encouraged to take locks of hair and hand prints, and to spend close family time together before bereavement.


The Swan card with helpline number, which is given to relatives

At the Northern Care Alliance NHS Group – which operates hospitals in Salford, Oldham, Bury, Rochdale and North Manchester – each hospital site has an end of life care resource room. This is accessible around the clock, and contains items such as memory boxes, comfort packs (which include basic toiletries, light snacks and a drink), personal message cards, foldable beds and blankets.

Range of resources

End of life and bereavement care teams wear uniforms bearing the Swan logo, cultural awareness posters about the model are distributed to all wards and departments, and free car parking vouchers are available for regular visitors of patients who are dying.

Each hospital site also has a ‘Swan suite’ in the bereavement offices, where families and loved ones can make an appointment to collect a death certificate and receive compassionate care from dedicated teams in a peaceful and private environment.   

The Swan model supports generalists to be specialists in end of life and bereavement care. It empowers staff, giving them permission to care and to break the rules that don’t exist.

Swan model of care

Care for individuals expected to die

  • Sign: Is the patient believed to be entering the dying phase of life? Start the individual plan of care and support for the dying person
  • Words: Sensitively communicate with the patient and family
  • Actions: Step outside the box and facilitate what is important to the patient and family
  • Needs: Are the needs of the patient and family being met, documented and reviewed regularly?
     

Care for families of individuals who have died suddenly or unexpectedly 

  • Sign: Ensure the provision of private space is identified
  • Words: Sensitively communicate with family
  • Actions: Step outside the box and facilitate what is important to the family
  • Needs: Are the needs of the family being met, documented and reviewed regularly?

 

Fiona Murphy is associate director of nursing, end of life, bereavement and donation care at Northern Care Alliance NHS Group. She will present a seminar on end of life and bereavement care at the RCNi Nursing Careers and Jobs Fair in Manchester on 7 February

Ms Murphy was also named Nursing Standard Nurse of the Year 2011. To nomination yourself or a colleague for this year’s RCNi Nurse Awards, click here 

RCNi Nursing Careers and Jobs FairsRCNi Nursing Careers and Jobs Fairs

RCNi Nursing Careers and Jobs Fairs are the largest CPD-accredited nursing recruitment events in the UK. Visitors can meet leading employers and agencies with immediate vacancies, and receive advice on finding a new job, revalidation, and climbing the career ladder.

If you're looking for a new job, or aiming to develop your nursing career in 2019, come along to our next event. Go to www.careersandjobsfair.com to book your free place today.


RCN Bulletin Jobs

RCN Bulletin Jobs is a one-stop resource for finding and applying for the best jobs in nursing and healthcare.

Hundreds of new posts are added every month and you can browse vacancies by field of practice, band or location.

Registration is quick, making it as simple as possible for you to take the next step in your career.

Find out more at www.rcnbulletinjobs.co.uk

This article is for subscribers only

Jobs