Palliative care nursing in Australia and the role of the registered nurse in palliative care
A blog post written by Dr. Rajkumar Cheluvappa
I currently work for the government in our local jurisdiction. Last year, a two-week stint at Clare Holland House (Palliative Care Services) opened my eyes to the depth, length, and importance of palliative care. It also corrected several misconstrued opinions that I previously held about palliative care as a discipline.
Palliative care is person and family-centred care given to a person expected to die with an ongoing advanced disease. The main aim is to give palliative care recipients the best possible quality of life. My 2022 palliative care paper ‘Palliative Care Nursing in Australia and the Role of the Registered Nurse in Palliative Care’ collated information pertaining to the practice of quality palliative nursing care in the Australian context.
The guiding values of palliative care are dignity, empowerment, compassion, equity, respect, advocacy, excellence, and accountability. Palliative care ameliorates pain and distress. It can be included soon after diagnosis of a condition with few or no prospects of recovery. Palliative care shows living and dying as a natural process without hastening or postponing death. Its holistic multi-disciplinary care approach maximises a care recipient’s activity, quality of life, and zest for life. This also includes addressing the care recipient’s spiritual and emotional needs. Moreover, quality palliative care caters not only to the care recipient, but also to his/her family by considering family circumstances and wishes concurring with the care recipient’s.
Once an individual is identified as suitable for palliative care, advance care planning is essential. Palliative care planning caters to the palliation of psychological, physical, spiritual, and existential distress and includes an individual’s family dynamics and the preclusion of conflicts. The palliative team will consider if the patient has an advanced care directive to refuse life-saving treatment or has appointed a Medical Treatment Decision Maker to take decisions on his/her behalf. Forthright and early discussions of end-of-life care with individuals and their families improve the quality of an individual’s final stages of life.
A palliative care nurse is expected to conform to Australian care standards set by Palliative Care Australia, the Nursing and Midwifery Board of Australia, and the National Safety and Quality Health Service. As a part of the multidisciplinary team involved in palliative care planning, the nurse regularly updates the care recipient’s goals and interests to give a sense of fulfillment in the care recipient’s life and ease the process of dying. As a core member of the multidisciplinary palliative care team, the registered nurse plays a pivotal role in patient empowerment, dignity, equity, respect, and advocacy.
I plan to integrate aspects of the relatively new concept of Strengths-Based Nursing into developing approaches of offering palliative care in remote communities.
A few other related areas of nursing research I am interested in also tie in well with the undergirding principles of palliative care. In my 2022 aged care nursing paper ‘Antipodean Perspectives – Aged Care Nursing and the Multifaceted Role of the Aged Care Nurse’, I have analysed approaches to promote evidence-based, culturally sensitive, holistic nursing practice that includes input from care recipients or their decision makers. As our recent publication shows, there is good guidance available for those providing palliative care in Australia and there are also areas where we can further improve.
Dr. Rajkumar Cheluvappa