For many years student nurses were trained in a more disciplined approach with considerable time allocated to working in the hospital environment and specified times allowed for gaining theoretical knowledge throughout their formal training. Nurses therefore gained a tremendous amount of experience and competency in their practical skills. With the introduction of more specialized equipment and technology it was now desirable to improve the professional status of nurses and nursing education. The introduction of university trained nurses has been met with much criticism. Student nurses are now being empowered and informed with theoretical knowledge from many health disciplines that allows them to use a holistic approach to patient care. The changes to nurse education were hoped to improve the professional status of nurses although this transition has not been without problems. Experienced nurses who are already working in stressful conditions with continuous staff shortages and poor recognition of service see the student nurse sometimes as an extra hindrance to their already increasing workload. Student nurses are theoretically competent but lack the clinical expertise and experience to complement this knowledge which can also add to the professional pressure that experience nurses encounter. Most nurses would like to see themselves, as promoters of nursing but are frustrated and disillusioned with their profession. It would seem then that student nurses as a result of this dissatisfaction are often devoured by some nurses instead of being encouraged and nurtured in their enthusiasm for nursing.
Objective: This quality improvement project aimed to explore the experience of home care nurse managers implementing a general palliative approach to care. Implementation comprised several interlinking activities encompassing stakeholder engagement and an education program in the outer eastern region of a home care and nursing organisation in Melbourne, Australia, between September 2019 and December 2020.Background: High quality provision of communitybased palliative and end-of-life care means people are much more likely to die at home, supported by family, friends and services. To achieve this, care staff must be adequately trained and supported, alongside a collaborative approach with other generalist and specialist providers. Study design and methods:This Case Study reports on the participant perspectives of the stakeholder engagement and education program. Focus groups and an interview were used to elucidate the experience of nursing and allied health professionals providing a general palliative approach in the community. The 2006 National Institute of Clinical Studies framework to identify barriers to best practice healthcare guided the development of focus group questions and the deductive analysis of data.Results: Seven Nursing Care Managers and one Social Worker participated in two online focus groups and one interview. Three overarching themes highlighted the value of tailored education in increasing staff knowledge and confidence, the factors for a successful generalist-specialist partnership, and the unique nature of the home care setting which requires accessible systems and processes.Discussion: This project supports assertions that generalist services can play a valuable role when a palliative approach to care is incorporated. It also underscores the importance of collaborative working partnerships between generalist and specialist services in providing quality community-based palliative care. Future research should examine the needs and perspective of clients, carers and families receiving a general palliative care approach in the community. Implications for research, policy and practice:Investment in developing the capacity and capability of generalist service staff to deliver palliative care AUTHORS GEORGINA JOHNSTONE BA/BSc BSc(Hons)(Psych) 1
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