Registered and Enrolled Nurses

Registered Nurses and Enrolled Nurses will be directly involved in providing palliative care in aged care. Their role includes:

  • providing leadership and direction to care workers
  • liaising with families
  • coordinating service delivery from GPs, allied health, palliative care teams and acute care
  • carrying out needs assessments and planning and reviewing care.

Nurses in residential aged care may not have direct access to palliative care specialists on-site. Like many other primary care health providers, they will continue to simultaneously provide rehabilitative and supportive care to residents’ who are not dying and end-of-life care to those residents who are dying. [1]

Staffing structures and work systems in residential aged care have been designed to promote wellness, quality of life and prevention of harm in a home like environment. This means they may not have been specifically designed to support palliative care. [2]

The ability of nurses in RAC to implement effective palliative care may be influenced by many factors. Some of these are listed below:

System / organisation factors

  • Staffing levels and expertise
  • Management support for palliative care, education and training
  • Physical structures, privacy, space for family to stay, meeting rooms for family conference
  • Lack of resources to support family eg, grief and bereavement counselling
  • Access to GP support and after hours pharmacy for medication changes

Knowledge / skills

  • Feeling comfortable and confident in discussing death and dying and end-of-life care
  • Difficulty in assessing needs of residents with cognitive impairment
  • Recognising dying and knowing when to implement palliative care
  • Concerns about administering analgesia

Family / resident

  • Knowing when it may be inappropriate or difficult for family to discuss resident’s dying for cultural reasons
  • The resident or family wanting to continue with active care that may not be beneficial
  • Family not being comfortable making decisions about care or not knowing what the resident would have wanted
  • Useful Tip

Remember to keep a record of the articles that you read when surfing the RAC section or any part of CareSearch. A journal or log of articles read, with a comment about content or relevance to your practice is evidence of continued professional development. This may be useful at staff appraisal time, when compiling your resume, or to meet APHRA competency to practice requirements

Last updated 19 March 2019