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

Arnaert, Antonia; Wainwright, Megan

doi:10.1017/s1478951509990290

Cited by 25 publications

(74 citation statements)

References 31 publications

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“…Complexity of work under significant time constraints increased stress (Cockerill et al, ; Tourangeau et al, ; Zeytinoglu & Denton, ), particularly for RNs (Williams, ). Inadequate time for prevention activities (Cockerill et al, ; Tourangeau et al, ) and the emotional impact of palliative care work were noted as stressors (Arnaert et al, ; Arnaert & Wainwright, ; Marchessault et al, ). Unmanageable workloads led to stress at home infringing on personal time through unpaid duties (e.g., paperwork) (Armstrong‐Stassen & Cameron, ).…”

Section: Resultsmentioning

confidence: 99%

Optimization of home care nurses in Canada: A scoping review

Ganann

Weeres

Lam

et al. 2019

Health Soc Care Community

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Nurses are among the largest providers of home care services thus optimisation of this workforce can positively influence client outcomes. This scoping review maps existing Canadian literature on factors influencing the optimisation of home care nurses (HCNs). Arskey and O'Malley's five stages for scoping literature reviews were followed. Populations of interest included Registered Nurses, Registered/Licensed Practical Nurses, Registered Nursing Assistants, Advanced Practice Nurses, Nurse Practitioners and Clinical Nurse Specialists. Interventions included any nurse(s), organisational and system interventions focused on optimising home care nursing. Papers were included if published between January 1, 2002 up to May 15, 2015. The review included 127 papers, including 94 studies, 16 descriptive papers, 6 position papers, 4 discussion papers, 3 policy papers, 2 literature reviews and 2 other. Optimisation factors were categorised under seven domains: Continuity of Care/Care; Staffing Mix and Staffing Levels; Professional Development; Quality Practice Environments; Intra‐professional and Inter‐professional and Inter‐sectoral Collaboration; Enhancing Scope of Practice: and, Appropriate Use of Technology. Fragmentation and underfunding of the home care sector and resultant service cuts negatively impact optimisation. Given the fiscal climate, optimising the existing workforce is essential to support effective and efficient care delivery models. Many factors are inter‐related and have synergistic impacts (e.g., recruitment and retention, compensation and benefits, professional development supports, staffing mix and levels, workload management and the use of technology). Quality practice environments facilitate optimal practice by maximixing human resources and supporting workforce stability. Role clarity and leadership supports foster more effective interprofessional team functioning that leverages expertise and enhances patient outcomes. Results inform employers, policy makers and relevant associations regarding barriers and enablers that influence the optimisation of home care nursing in nursing, intra‐ and inter‐professional and inter‐organisational contexts.

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Section: Resultsmentioning

confidence: 99%

Optimization of home care nurses in Canada: A scoping review

Ganann

Weeres

Lam

et al. 2019

Health Soc Care Community

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“…9,10 Furthermore, indications are that ambiguity regarding teamwork may give room to local-level interpretations; 11 and, consequently, lack of teamwork can easily be pointed out as the main problem even though organizational structures and issues may be contributing. Palliative care is a complex field including medical, ethical, psychological, social, existential, and emotional dimensions.…”

Section: Introductionmentioning

confidence: 99%

Team Interactions in Specialized Palliative Care Teams: A Qualitative Study

Klarare

Hagelin

Fürst

et al. 2013

Journal of Palliative Medicine

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Background: Teamwork is a standard of care in palliative care and that is emphasized by leading organizations. When interdisciplinary teams communicate their varied assessments, outcomes may be more than additive due to the synthesis of information. Interprofessionality does not guarantee multidimensionality in health care interventions, however, and that interprofessional teams promote collaboration may be questioned. Aim: The aim was to explore team interaction among team members in specialized palliative care teams. Design: Semistructured interviews were conducted with health professionals working in specialized palliative home care teams. The interviews were analyzed by content analysis. Setting/participants: Participants were recruited from specialized palliative care units in Sweden. The 15 interviewees included 4 men and 11 women. Physcians, nurses, paramedical staff, and social workers were included. Results: Organizational issues like resources and leadership have a great impact on delivery of care. Competence was mirrored in education, collaboration, approach, and support within the team; while communication was described as key to being a team, resolving conflict, and executing palliative care. Conclusion: Communication and communication patterns within the team create the feeling of being a team. Team climate and team performance are significantly impacted by knowledge and trust of competence in colleagues, with other professions, and by the available leadership. Proportions of different health professionals in the team have an impact on the focus and delivery of care. Interprofessional education giving clarity on one's own professional role and knowledge of other professions would most likely benefit patients and family caregivers.

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“…Arnaert & Wainwright and Selman et al remarked this complexity, highlighting the need for a continuous professional training focused on those aspects [32,46]. Indeed, many participants expressed, at the end of the Master programme, the need for further training focused on those often idealized but complex competences, underlining the idea that education on communication skills is never enough.…”

Section: Do We Need a More Inclusive Model For Understanding Ethics Imentioning

confidence: 99%

“…There is an increasing demand for strategies capable to gather the implicit dimensions of nursing competence in PC [31,32,28]. Qualitative instruments as interviews, focus groups (FGs), and autobiographical writings could be useful to explore that aspect of nurses' expertise and to better evaluate the development of competence in PC during and after training experiences [33][34][35].…”

mentioning

confidence: 99%

Becoming Competent in Palliative Care as Perceived by Nurses Attending a Master Programme. A Qualitative Study

M¹

2017

PMCOA

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

Cited by 25 publications

References 31 publications

Optimization of home care nurses in Canada: A scoping review

Optimization of home care nurses in Canada: A scoping review

Team Interactions in Specialized Palliative Care Teams: A Qualitative Study

Becoming Competent in Palliative Care as Perceived by Nurses Attending a Master Programme. A Qualitative Study

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