Bringing palliative care expertise to a general medicine ward: Supporting patients and families when they need it most
An article written by Dr Jianxia Zhai, Lecturer in Nursing, School of Health and Biomedical Sciences, STEM College, RMIT University
When older patients are admitted to hospital with multiple chronic illnesses, their care is often complex. Families can feel overwhelmed, and health professionals sometimes struggle to balance medical treatment with the emotional and supportive needs of patients. These challenges leave patients and families feeling unheard, and staff under pressure to provide care that felt incomplete.
This experience drew me to research how palliative care expertise might better support patients at high risk of mortality (with a prognosis of three months or less to live), families and clinicians (nursing and allied health staff) in a busy hospital ward. Our study focused on embedding a palliative care nurse consultant (PCNC) into a general medicine ward in a metropolitan hospital, to see how this role could influence care, communication and outcomes.
Drawing on interviews and ward observations, our research explored how the PCNC worked alongside clinicians in a general medicine ward to provide guidance on complex cases, support families in making difficult decisions, and advocate for patients’ preferences. The findings highlight that even a single dedicated role can make a profound difference. [1]
Families told us they felt more reassured when someone took the time to explain options clearly and provide emotional support, not only medical facts. Staff valued having a colleague they could call on to help navigate conversations about goals of care, advance care planning, or transitions to residential or palliative services.
At the same time, our study revealed the challenges of embedding this role. Hospitals are busy places, and introducing new ways of working requires negotiation, trust and collaboration. Not every clinician was familiar with the scope of palliative care, and part of the PCNC’s work was to demonstrate the value of their expertise in real time, whether that was by easing a patient’s distress, supporting junior doctors, or helping a family prepare for next steps.
Our research highlights that supportive care should not be limited to the final stage of life. Instead, it should be integrated into routine hospital care for patients with complex and chronic conditions. Many patients benefit from attention to comfort, communication, and emotional wellbeing much earlier than we might expect. By embedding a PCNC in a general medicine ward, we created a bridge between specialist palliative care and everyday hospital practice in a general medicine ward, ensuring that patients and families received holistic support alongside their medical treatment.
This approach reflects the principles of value-based healthcare. It recognises that what matters most is not only survival or length of hospital stay, but also the quality of the experience for patients and families, the alignment of care with personal values, and the confidence of staff to deliver compassionate, coordinated care. The PCNC role demonstrated how investing in person-centred support can improve the outcomes that people truly value.
Looking ahead, we call for health services to consider how supportive care can be built into everyday practice. This may involve training, role redesign, and stronger collaboration between specialist teams and general wards. Most importantly, it means recognising that high-quality hospital care is not only about treating disease, but also about supporting the whole person and their family.
Our research contributes to a growing understanding that small changes in staffing models can ripple out to create more compassionate, coordinated and value-based care. Embedding palliative care expertise in general medicine is one example of how hospitals can adapt to meet the needs of an ageing population, ensuring patients and families feel supported, and clinicians are better equipped to provide care that truly matters.
To learn more, please read our article.
References
- Zhai J, Mooney C, Hamilton O, Vesty G, Millar R, Runacres F, et al. Embedding a palliative care nurse consultant within a general medicine ward: A prospective exploratory study. J Clin Nurs. 2025.
Author
Dr Jianxia Zhai
Lecturer in Nursing, School of Health and Biomedical Sciences, STEM College
RMIT University