Palliative care and the nurse's role

Background: Palliative care refers to interdisciplinary patient and family-centered care that optimizes quality of life by anticipating, preventing, and alleviating suffering across the continuum of a patient"s illness. Palliative care is crucial in clinical management and helps patients and families dealing with disease related symptoms and psychological implications. Given their focus on providing patient and family centered healthcare, nurses are often the first to recognize the need for palliative care that is consistent with nursing standards and code of ethics. The nurse"s role as a generalist in palliative care has been growing, and yet has not been fully defined.Purpose: This review of the literature will discuss from a global perspective the evidence supporting the nurse"s role in palliative care as a strategy to address the needs of patients and their families.Methods: We searched electronic databases for relevant articles reporting the nurse"s role in palliative care. We searched PubMed, CINAHL, and EBSCO electronic databases for relevant articles reporting the nurse"s role in palliative care. We found 37 articles that fit our search criteria and thoroughly reviewed these manuscripts. From these articles, we extracted the common elements of palliative care in nursing and successful interventions and trainings.Results: The main areas in which nurses globally implemented palliative care was in their roles as (1) health care leaders, (2) patient and family advocates; and (3) expert communicators with patients, families, and other members of the health care system. Although it is clear that nurses are well positioned to provide palliative care to patients and families, it is unclear what types of resources as the institutional and administrative level are available for nurses to be supported when providing palliative care. While a few nurse-led interventions demonstrated significant outcomes on patients" quality of life and improved end of life care, the overall lack of clinical trials and evidence-based protocols remains a glaring area of need within nursing research and evidence based care. Nurses provide palliative care across all levels of the health care system, however few studies have systematically tested the results of nurse led palliative care.Conclusion: To expand the influence nurses have in palliative care, future quality improvement and research projects should consider documenting and examining the impact of palliative care delivered by nurses. There is a paucity in the literature of nurse led palliative care research. Globally, the nurse"s role as a generalist in palliative care has been growing, and yet has not been fully defined.Target Audience: The target audience is clinical nurses, nurse leaders, administrators, educators and nursing students.