In search of legitimacy – registered nurses’ experience of providing palliative care in a municipal context

Abstract

The results pinpoint the importance of increased acknowledgement of nurses' knowledge and skills and a critical view on the effects of moving towards an organization composed of different consultants, which can lead to even more unclear responsibility for nursing care provision.

The nurse's role in palliative care: A qualitative meta‐synthesis

“…(), one half of the nurses said the doctors handled care for end‐of‐life patients, even though the doctor saw the patients the least. In a Swedish study (Törnquist et al., ), the findings show that the physicians did not listen to the nurses and did not want to prescribe in accordance with their advice, even though the nurses were more familiar with the patients. In this culture and context the doctor was likely to be the lead care provider.…”

“…Across several continents and contexts, the nurses described their role as being the patient's advocate (Arbour & Wiegand, ; Howell et al., ; McCallin, ; McCallum & McConigley, ; Raphael et al., ; Törnquist, Andersson, & Edberg, ; Verschuur, Els, Groot, & van der Sande, ). In this role nurses watched over the quality and continuity of care.…”

“…The nurses' availability made them natural points of contact for the patient and the family, as well as for other health professionals. Hence, the nurses described themselves as coordinators of services, aiming at providing care for the patients and their families (Austin et al., ; Daines et al., ; Hopkinson, Hallett, & Luker, ; Howell et al., ; King et al., ; Raphael et al., ; Törnquist et al., ; Wallerstedt & Andershed, ). Schaepe, Campbell, and Bolmsjo () showed that nurses, whether working in home care or hospital in Uganda, described their role as “spiders in a web.” Their work was characterised by networking with other professionals and between the patient and the family.…”

“…() the nurses working in UK home care, appeared as “gatekeepers” to services provided by other professionals. The nurses described their provision of palliative care in four Swedish municipalities as at times even buffering the effect of the many different care providers and unclear responsibilities (Törnquist et al., ). The study by King et al.…”

Nurse-Perceived Communication Challenges and Roles on Interprofessional Care Teams

“…10 Nurses working to provide high-quality palliative care describe having limited authority in relation to other care providers and report having to cushion the effects of unclear responsibilities between organizations. 11 As a result of uncertainty about team roles, palliative team members describe inconsistent prognosis communication with patients and families. 12 Nurse leaders working within teams need to be cautious about territoriality among team members and have the ability to succeed beyond their own disciplinary boundaries.…”