Palliative care nurses are on the forefront of modern health care because of the vital and unique need they serve in bridging the gap between those who are seriously ill and those who require hospice care. As medical technology innovations continue to revolutionize the health care landscape, an inevitable outcome is that patients are living longer and even surviving diseases that were once thought to be a certain death sentence. While that news is welcome to patients and families, it also comes with a steep price—longer life frequently means more suffering. For instance, Medwire News recently reported that Medicare’s SNF (Skilled Nursing Facilities) benefit for the last six months of life, which does not cover most palliative and hospice care, is over-utilized for elderly adults whose expected outcome is death.
In view of these life and death realities, palliative care is an emerging trend in nursing practice. But what is palliative care, and what do nurses need to know about it?
Palliative Care Defined
According to GetPalliativeCare.org, a site dedicated to helping people cope with serious illnesses, palliative care is “specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness.” The Last Acts Task Force similarly defined palliative care as “the comprehensive management of the physical, psychological, social, spiritual, and existential needs of patients, particularly those with incurable, progressive illness.”
The desired outcome for palliative care nurses is to improve the quality of life for patients who have been diagnosed with illnesses that cause great pain and discomfort, such as Amyotrophic Lateral Sclerosis (ALS), cancer, dementia, kidney failure, chronic obstructive pulmonary disease (COPD), and congestive heart failure, among many others. Whereas hospice patients are expected to live a month or less, palliative care patients will generally live longer.
Palliative care is aimed at ameliorating symptoms such as chronic pain, fatigue, insomnia, and breathing difficulties, so that patients can regain their strength and live more fulfilling lives in the time they have left. Palliative care also supports the families of afflicted patients by alleviating their agony from seeing a loved one in pain.
Palliative Care Nursing Duties
Palliative care nurses work in an interdisciplinary, collaborative context. They work with a team of providers, such as treating physicians, social workers, volunteers, home health aides, family members, and chaplains. These nurses provide expert management of pain and discomfort through medication, as ordered by physicians.
Palliative care nurses provide an even more important service to those who are suffering. Palliative care nurses have expert training in compassionate listening and counseling skills. They are able to interact with patients in a respectful, empathetic, and culturally sensitive manner, and they understand loss, grief, and end-of-life processes.
Hospice nurses provide similar care, but since their patients have a poorer prognosis, they generally work in a home or hospice setting. Palliative care nurses, however, treat patients who are likely to live for longer periods, so they work in medical facilities such as hospitals, rehabilitation centers, and nursing homes.
Palliative Care Nursing Professional Organizations
There are several professional associations that support palliative care nurses, advance the interests of palliative care, and educate the general public. The Hospital and Palliative Nurses Association accepts nurses of all levels as members, and provides materials for educators, researchers, students, patients, families, and other medical practitioners. Its goal is to provide education, networking, and mentoring, and it also supports research about palliative care. The National Hospice and Palliative Care Organization provide news, career resources, and education, including online learning. It also contains a searchable database of palliative care providers. Finally, the American Academy of Hospice and Palliative Medicine allows palliative care nurses to join as affiliate members, which provides access to research, practice tools, clinical guidelines, and research.