Nurses’ required end‐of‐life care competence in health centres inpatient ward – a qualitative descriptive study

Abstract

Background Studies of nurses’ required competence in EOL care in health centres are rare. It is important to produce information about experienced nurses’ perceptions of the competence they consider important in their practical work. Aim The aim of this study was to describe nurses’ required competence in EOL care in health centre inpatient wards as experienced by nurses. Method A descriptive qualitative study using four semi‐structured group interviews (20 nurses) and inductive descriptive content analysis. Results Five categories describing nurses’ required competence in EOL care in a health centre inpatient ward were identified: (1) ethics and courage in action, (2) support for the patient, (3) support for the family, (4) care planning and (5) physical care. Factors promoting nurses’ competence in EOL care comprised two categories: (1) professional development in EOL care and (2) an organisation that supports EOL care. Conclusions End‐of‐life care in health centre inpatient wards requires wide and complex competence from nurses. Nurses’ experiences of required competence are associated with holistic care of the patient, encountering the family and multiprofessional cooperation. Nurses’ competence in EOL care could be enhanced with postgraduate education, and educational planning should be given more attention in the future.

Paramedics’ experiences and educational needs when participating end-of-life care at home: A mixed method study

“…Paramedics also requested for more education in encountering, communication, supporting, and counseling in end-of-life care. Our results are in line with previous studies, which identified supporting the patient and her/his family and carers as a nursing competence required by the professionals working in the basic level of palliative care 27–30,37 as well as in palliative paramedicine. 22 The importance of encountering is also highlighted by family members of end-of-life patient as they are shown to emphasize professionalism and compassion of the paramedics’.…”

“…Symptom management and use of opioids have been identified as ethical challenges also in previous studies 36 and competence in managing the most common symptoms as one of the main nursing competences in basic palliative care. 28–30…”

“…13,18,23,31 Competency to collaborate with health care team is regarded as one of the nursing competencies in palliative care in general. 28,29 Demands for collaboration skills emphasizes when working out-of-office hours with changing co-workers, like paramedics do. Our and previous studies highlights the importance of teamwork in the training of paramedics as well as in the function of palliative care pathways.…”

“…Symptom management and use of opioids have been identified as ethical challenges also in previous studies 36 and competence in managing the most common symptoms as one of the main nursing competences in basic palliative care. [28][29][30] Although encountering and psychosocial support are the cornerstones of palliative care, education on main aspects of somatic symptom control should not be overlooked. This was further highlighted by the finding that knowledge and skills for the use of patient controlled analgesia device was still regarded as an important issue.…”

“…6,25,26 Healthcare personnel need a wide range of competencies to provide high quality palliative care. [27][28][29][30] Paramedics are trained in decision-making processes, communication, handover processes, analgesic care, and acting as mediators between the pre-and in-hospital services. 17 These competencies may also help them to offer palliative care.…”