The Nurses role in symptom and medication management

Managing symptoms is core business for palliative care. The management of medicines is a problem. It is estimated that more than half of people with a chronic condition fail to take their medicines as prescribed. This has flow on effects of increased risk of adverse drug reactions, exacerbations of underlying conditions and costs.

Nurses are available to patients in a number of means providing an opportunity to identify and discuss symptom management and medication management problems. This may be in relation to non-pharmacological approaches as well as administering medication as prescribed, supporting others in this role, or in providing feedback to the prescriber. Patients and families will also require advice and support including information on the medications that they are taking and nurses will often fulfil this role.

Recognising deterioration

Recognising a person's needs and state of health is essential to good symptom and medicines management. The Supportive and Palliative Care Indicators Tool (SPICT) is a validated tool that you can use to assess deterioration for a range of advanced serious conditions. If you answer 'yes' to any of the questions this indicates that it is time to assess the person’s holistic needs and start planning future care with them. CareSearch has developed interactive versions of the SPICT (297kb pdf) and SPICT4ALL (307kb pdf) forms for online use.

SPICT4ALL (307kb pdf)

When to use SPICT or SPICT-4ALL

  • After an unplanned hospital admission or a decline in health status
  • For people with poorly controlled symptoms
  • To identify people who are increasingly dependent on others due to deteriorating function, general frailty and/or mental health problems for additional care and support
  • To identify people (and carers) with complex symptoms or other needs
  • To assess decision-making capacity
  • To identify people who need proactive, coordinated care in the community from the primary care team and/or other community staff and services
  • To agree, record and share an Advance/Anticipatory Care Plan.

To learn more about using this tool visit the SPICT website. The following section provides more information on the common symptoms and medications in palliative care.


Last updated 20 August 2021