Hostname: page-component-77c89778f8-vsgnj Total loading time: 0 Render date: 2024-07-16T11:47:48.788Z Has data issue: false hasContentIssue false
  • English
  • Français

Providing care and sharing expertise: Reflections of nurse-specialists in palliative home care

Published online by Cambridge University Press:  30 September 2009

Antonia Arnaert  and
Megan Wainwright
Antonia Arnaert*
Affiliation:
School of Nursing, McGill University, Montreal, Quebec, Canada
Megan Wainwright
Affiliation:
School of Nursing, McGill University, Montreal, Quebec, Canada Department of Oncology, McGill University, Montreal, Quebec, Canada
*
Address correspondence and reprint requests to: Antonia Arnaert, McGill University, School of Nursing, 3506 University Street, Montreal, Quebec H3A 2A7, Canada. E-mail: antonia.arnaert@mcgill.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This study explored the experiences, perspectives, and reflections of five nurse-specialists in palliative home care, whose dual role includes caring for patients in their daily practice as well as sharing their knowledge, skills, expertise, and experiences with other home care nurses in the community.

Methods:

A qualitative research design, incorporating face-to-face semistructured interviews, was used. Interviews were based on open-ended questions such as: “What is your experience in providing palliative home care to patients and their families? How do you feel about sharing your expertise and experiences with home care nurses?” Data were content analyzed using the constant comparative method.

Results:

Three major themes and a number of subthemes emerged: (1) acknowledging one's own limitations and humanness: (a) calling for backup, (b) learning as we go along, (c) coping with emotional demands, and (d) interacting with family members; (2) building a collaborative partnership: (a) working collaboratively, (b) sharing information, (c) guiding home care nurses, and (d) being nonjudgmental; and (3) teamwork and implementing palliative home care teams.

Significance of results:

Nurse-specialists play a key role in palliative home care as both carers and as resources of expert knowledge for other home care nurses caring for palliative patients. As the population ages, the health care system will be faced with increasing requests for high-quality palliative home care. The results of this study demonstrate that, from the perspective of the nurse-specialists of NOVA-Montréal (a nonprofit social and health service organization), nurse-specialists can work collaboratively with home care nurses to improve patients' quality of care and their quality of life. Moreover, patients and their families would benefit from the more widespread establishment of palliative care teams within community health organizations.

Keywords

Palliative careHome care nurseNurse-specialistCollaborative partnership
Type
Review Articles
Information
Palliative & Supportive Care , Volume 7 , Issue 3 , September 2009 , pp. 357 - 364
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Aitken, A. (2006). District nurses' triggers for referral of patients to the Macmillan nurse. British Journal of Community Nursing, 11, 100, 102–104, 106–107.Google Scholar
Benner, P. (1984). From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Menlo, CA: Addison-Wesley.Google Scholar
Bestall, J.C., Ahmed, N., Ahmedzai, S.H., et al. (2004). Access and referral to specialist palliative care: Patients' and professionals' experiences. International Journal of Palliative Nursing, 10, 381–389.Google Scholar
Billet, S. (1996). Towards a model of workplace learning: The learning curriculum. Studies of Continuing Education, 18, 72–75.Google Scholar
Boston, P.H. & Mount, B.M. (2006). The caregiver's perspective on existential and spiritual distress in palliative care. Journal of Pain and Symptom Management, 32, 13–26.Google Scholar
Canning, D., Rosenberg, J.P. & Yates, P. (2007). Therapeutic relationships in specialist palliative care nursing practice. International Journal of Palliative Nursing, 13, 222–229.Google Scholar
Chapple, A., Zielbaldn, S. & McPherson, A. (2006). The specialist palliative care nurse: A qualitative study of the patients' perspective. International Journal of Nursing Studies, 43, 1011–1022.Google Scholar
Corner, J. (2003). Nursing management in palliative care. European Journal of Oncology Nursing, 7, 83–90.Google Scholar
Corner, J., Clark, D. & Normand, C. (2002). Evaluating the work of clinical nursing specialist in palliative care. Palliative Medicine, 16, 275–277.Google Scholar
Davies, B. & Orbele, K. (1990). Dimensions of the supportive role of the nurse in palliative care. Oncology Nursing Forum, 17, 87–94.Google Scholar
Ellershaw, J. & Ward, C. (2003). Care of the dying patient: The last hours and days of life. British Medical Journal, 326, 30–34.Google Scholar
Gottlieb, L.N. & Feeley, N. (2006). The Collaborative Partnership Approach to Care. A Delicate Balance. Toronto: Elsevier.Google Scholar
Groot, M.M., Vernooij-Dassen, M.J.F.J., Courtens, A.M., et al. (2005). Requests from professional care providers for consultation with palliative care consultations teams. Supportive Care in Cancer, 13, 920–928.Google Scholar
Hollis, R. (2005). The role of the specialist nurse in paediatric oncology in the United Kingdom. European Journal of Cancer Care, 41, 1758–1764.Google Scholar
Husband, J. & Kennedy, C. (2006). Exploring the role of community palliative care nursing specialists as educators. International Journal of Palliative Nursing, 12, 277–284.Google Scholar
Jannings, W. & Armitage, S. (2001). Informal education: A hidden element of clinical nurse consultant practice. Journal of Continuing Education in Nursing, 32, 54–59.Google Scholar
Jo, S., Brazil, K., Lohfeld, L., et al. (2007). Caregiving at the end of life: Perspectives from spousal caregivers and care recipients. Palliative and Supportive Care, 5, 11–17.Google Scholar
Kennedy, C. (1998). Ways of knowing in palliative nursing. International Journal of Palliative Nursing, 4, 240–245.CrossRefGoogle Scholar
LaSala, C.A., Connors, P.M., Pedro, J.T., et al. (2007). The role of the clinical nurse-specialist in promoting evidence-based practice and effecting positive patient outcomes. Journal of Continuing Education in Nursing, 38, 262–270.Google Scholar
Leggat, S.G. (2007). Effective healthcare teams require effective team members: Defining teamwork competencies. BMC Health Services Research, 7, 17.Google Scholar
Lewis, D. & Anthony, D. (2007). A patient and carer survey in a community clinical nurse-specialist service. International Journal of Palliative Nursing, 13, 230–236.Google Scholar
Maylor, M. (2005). Differentiating between a consultant nurse and a clinical nurse-specialist. British Journal of Nursing, 14, 463–468.Google Scholar
Meier, D.E., Thar, A., Jordan, A., et al. (2004). Integrating case management and palliative care. Journal of Palliative Medicine, 7, 119–134.Google Scholar
Polanyi, M. (1962). Personal Knowledge: Towards a Post-Critical Philosophy. London, UK: Routledge and Kegan Paul.Google Scholar
Qaseem, B., Shea, J., Conner, S.R., et al. (2007). How well are we supporting hospice staff? Initial results of the survey of team attitudes and relationships (STAR) validation study. Journal of Pain and Symptom Management, 34, 350–358.Google Scholar
Seymour, J., Clark, D., Hughes, P., et al. (2002). Clinical nurse-specialists in palliative care. Part 3. Issues for the MacMillan Nurse Role. Palliative Medicine, 16, 386–394.Google Scholar
Sharkey, S., Larsen, L. & Mildon, B. (2003). An overview of home care in Canada: Its past, present, and potential. Home Health Care Management & Practice, 15, 382–390.Google Scholar
Simpson, M. (2003). Developing education and support for community nurses: Principles and practice of palliative care. Nursing Management, 9, 9–12.CrossRefGoogle ScholarPubMed
Skilbeck, J., Corner, J., Bark, P., et al. (2002). Clinical nurse-specialists in palliative care. Part 1. A description of the Macmillan Nurse caseload. Palliative Medicine, 16, 285–296.Google Scholar
Storey, L., O'Donnell, L. & Howard, A. (2002). Developing palliative care practice in the community. Nursing Standard, 17, 40–42.Google Scholar
Strandberg, E.L., Ovhed, I., Borgquist, L., et al. (2007). The perceived meaning of a (w)holistic view among general practitioners and district nurses in Swedish primary care: A qualitative study. BMC Family Practice, 8, 8.Google Scholar
Strauss, A. & Corbin, J. (1990). Basics of Qualitative Research: Grounded Theory, Procedures and Techniques. Newbury Park, CA: Sage.Google Scholar
Tzuh Tang, S. & McCorkle, R. (2003). Determinants of congruence between the preferred and actual place of death for terminally ill cancer patients. Journal of Palliative Care, 19, 230–237.Google Scholar
Yuen, K.J., Behrndt, M.M., Jacklyn, C., et al. (2003). Palliative care at home: General practitioners working with palliative care teams. The Medical Journal of Australia, 179(6 Suppl.), S38–S40.Google Scholar