• Natalie Elizabeth Anderson, Julia Slark, Kate Faasse, and Merryn Gott.
• School of Nursing, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand; Auckland Adult Emergency Department, Auckland District Health Board, Auckland, New Zealand. Electronic address: na.anderson@auckland.ac.nz.
• Australas Emerg Care. 2019 Sep 1; 22 (3): 156-161.

BackgroundAround the world, many paramedics are authorised to withhold or terminate resuscitation. Research indicates this can be a challenging part of their role. Little is known about graduating paramedic student confidence, concerns and learning in this area.MethodsAn online cross-sectional survey of students nearing completion of a paramedic degree in New Zealand, including piloting of a newly-developed confidence scale.ResultsSeventy-two participants reported varying exposure to termination of resuscitation and patient death. Participants felt most confident providing technical procedurally-based care and least confident with non-technical skills. Participants' greatest concerns included making 'the right call', supporting grieving family, controlling emotions and encountering conflict. Clinical exposure with supportive mentoring, clinical simulation, peer reflection and resolved personal experience with death, were considered most useful for professional development.ConclusionsExposure to termination of resuscitation and management of the scene of a patient death is variable amongst graduating paramedics. Novice paramedics may benefit from opportunities to observe and rehearse non-technical skills including delivering death notification and communicating with bystanders and bereaved family. The Confidence with Resuscitation Decision-Making and Patient Death Scale has favourable psychometric properties and utility as an outcome measure for future research in this area.Copyright © 2019 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

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