The ACN review noted that: [ref 1] '…there is a large nursing workforce providing palliative care on a day-to-day basis in contexts such as chronic disease management, aged care, or general medical care. These nurses are often not considered ‘specialists’ in palliative care, yet they provide essential nursing services and require appropriate knowledge, competence and skills to ensure they deliver key elements of quality palliative care. Other nurses practice in purpose-designed specialised palliative care unites in hospitals or the community and require an advanced level of knowledge and skill.'
Examination of the evidence showed that Nurse-led models of palliative care mostly provided by nurses working in advanced practice roles deliver statistically significant benefits for patients, services or the health system.  Key components of effective models were:
- symptom management,
- goals of care discussions,
- patient education, and
- care coordination.
From this we understand that nurses skilled in palliative care are needed in all settings and those with advanced training provide needed leadership to implement effective models of care. As the demand for palliative care increases it will be important to ensure that current and next generation nurses are trained and supported to develop skills in symptom management, communication and care coordination, and to take up advanced practice roles.
What the numbers tell us:
The number of employed nurses and midwives, and number of enrolled student nurses both increased between 2013 and 2017. But where those increases are happening varies across the community. Substantial increases in the number of nurse practitioners with advanced training are encouraging as are the increases in general practice nurses. Growth in palliative care nurses is more moderate.