Rewards of being a palliative care nurse
The World Health Organization (WHO) describes nursing as encompassing autonomous and collaborative care of individuals of all ages, and their families. Groups and communities, sick or well and in all care settings. It includes promotion of health, prevention of illness, care of the ill, disabled and dying people.
Nurses, no matter where they work, or in whatever area of practice will care for patients who have palliative care needs and those who require end-of-life care. Whether a new graduate, a practice nurse, aged care, paediatrics, community nurse , other specialties’ or working in specialist palliative care, nurses need to continue to develop their clinical skills. This includes communication skills, and understanding of palliative care to provide appropriate physical, emotional, cultural, spiritual and practical needs of patients and their families which are based on valuing their end of wishes.
The essence of the WHO definition of palliative care "improves the quality of life of patients and their families facing life-threatening illness, through prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psycho-social and spiritual” should be at the core of nursing.
Palliative Care Nurses Australia (PCNA) recognises that all nurses are uniquely placed to shape and improve the delivery of palliative care. Nurses spend the greatest period of time with patients and can advocate for their needs as well as providing care.
The rewards of palliative care nursing are many and include the human connection to not only the patient, but also their carer/family; establishing relationships built on trust, maintaining realistic hope, respecting choice, relief of, or improvement of symptoms, the privilege “to be with” someone who needs a listening ear, their hand held at a time of loneliness or fear, and being present with a dying patient and supporting families in their time of grief.
A typical day for a palliative care nurse
Similar to all aspects of nursing, structure, routine and policy drive palliative care nursing however spontaneity, adaptability, responsiveness and urgency are also key. Death and dying does not keep to a schedule and nurses often need to navigate complex situations which may include sudden deterioration, hemorrhage, delirium, rapid transfer to home for end of life care, managing large groups of family who are with the patient, and requests from patients and/or families to celebrate significant events such as weddings, birth of grandchildren or cultural specific requests including return to country for Aboriginal people.
Community palliative care nurses are at the forefront of care coordination, navigating patient needs and planning ahead to support and educate carers regarding medication requirements and indications. On a daily basis nurses interact with GPs, generalist community nurses, allied health, pharmacists, after hours medical services, ambulance services, hospital services, DVA providers, NDIS providers, aged care package providers, interpreters and many more.
The essence of any typical day for a specialist palliative care nurse in all care settings includes the principles of holistic care, interdisciplinary teamwork, humor and compassion.
Resources that can help
To continue to develop their own practice and stay up to date with current projects, research and specialty news both nationally and internationally nurses are encouraged to join professional networks.
The leading nursing organisation for palliative care nursing is PCNA support nurses through education webinars, conferences, policy and practice statements, mentoring program, and career planning.
In addition their own State/Territory based Palliative Care Association will keep them informed of local policy, programs, funding initiatives and multi-disciplinary education events. At a National level Palliative Care Australia (PCA) provides regular newsletters, Commonwealth policy, strategic directions, and national education initiatives.
A National Commonwealth program, administered in each State/Territory: Program Experience Palliative Approach (PEPA) aims to provide non Palliative Care Specialist nurses an opportunity for a short placement in palliative care.
The caring@home project is an important new program that nurses nationally are embracing to prepare and teach carers in managing breakthrough symptoms safely with subcutaneous medications.
Nurses working in acute hospitals in any specialty will benefit from End-of-Life Essentials whilst nurses in RACF should consider further exploration of the End of Life Directions for Aged Care (ELDAC) and advocating for this program within their facility or RACF group.
CareSearch and palliAGED are recommended sites for all nurses to stay updated with clinical evidence, patient and carer resources and education programs.
An important aspect of palliative care nursing is to develop skills in reflective practice, to seek out a mentor who you can seek guidance, and to embrace clinical supervision as a positive step in assisting in your individual professional development, cope better with your work, workplace, improve your practice and reduce burn-out. A good starting resource is the Self Care Matters information, videos and tools on the Palliative Care Australia website.
Palliative Care Nurses Australia (PCNA) welcomes you to contact us if you would like to find out more about benefits of membership.
Janeane Harlum, District Palliative Care Manager & Service Development at South Western Sydney Local Health District and President for Palliative Care Nurses Australia (PCNA)