In May 2021, the National Academies of Sciences, Engineering, and Medicine released the Future of Nursing 2020-2030—Charting a Path to Health Equity. The report provides an in-depth analysis of the history and evidence of structural racism, the role of social determinants of health, and the role of nurses improving health equity in times of conventional care, disasters and crises, and public health emergencies. Palliative nurses are integral to impacting health equity for individuals with serious illness. Three strategies can help palliative nurses provide more equitable palliative care: 1) develop a more culturally sensitive practice and communication skill; 2) learn about the elements of social determinants of health to perform a simple Social Determinants of Health assessment as part of every patient's assessment; and 3) gather a list of community resources to help direct patients to resources.
Community-based palliative care is developing rapidly, with increasing diversity in program design and reimbursement structures. Yet many patients living with serious illness still lack access to reliable community-based palliative services in their homes. Advanced practice registered nurses (APRNs) possess a unique skill set and are able to meet the complex needs of seriously ill patients and their families. APRNs are leaders in developing and providing community-based palliative care. In addition to expertise in comprehensive and holistic assessment skills, expert-level pain and symptom management, and advanced communication skills, the APRN needs to have an understanding of program structure and sustainability. The work of APRNs in community-based palliative care needs to be supported and the barriers to practicing at the highest level of ability and scope of practice need to be removed for the preservation of the role and to benefit patients with serious illness.
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