The Hospice and Palliative Care Advanced Practice Registered Nurse Workforce

Pawlow, Patricia; Dahlin, Constance; Doherty, Caroline; Ersek, Mary

doi:10.1097/njh.0000000000000449

Cited by 22 publications

(25 citation statements)

References 13 publications

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“…Likewise, novel mechanisms are needed to provide federal funding for specialty-level graduate education (analogous to graduate medical education) and training to nonphysician palliative care professionals, given the evidence that interdisciplinary clinicians practicing specialty palliative care report a lack of education in the necessary knowledge and skills during their academic preparation. 25 Third, we recommend support for additional research into the workforce capacity and growth…”

Section: Policy Implications and Opportunitiesmentioning

confidence: 99%

Policy Changes Key To Promoting Sustainability And Growth Of The Specialty Palliative Care Workforce

et al. 2019

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Specialized palliative care teams improve outcomes for the steadily growing population of people living with serious illness. However, few studies have examined whether the specialty palliative care workforce can meet the growing demand for its services. We used 2018 clinician survey data to model risk factors associated with palliative care clinicians leaving the field early, and we then projected physician numbers from 2019 to 2059 under four scenarios. Our modeling revealed an impending "workforce valley," with declining physician numbers that will not recover to the current level until 2045, absent policy change. However, sustained growth in the number of fellowship positions over ten years could reverse the worsening workforce shortage. There is an immediate need for policies that support high-value, team-based palliative care through expansion in all segments of the specialty palliative care workforce, combined with payment reform to encourage the deployment of sustainable teams.

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Section: Policy Implications and Opportunitiesmentioning

confidence: 99%

Policy Changes Key To Promoting Sustainability And Growth Of The Specialty Palliative Care Workforce

et al. 2019

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“…Palliative care involves treatment of individuals who have life-threatening illnesses, in which a cure or complete reversal of the disease and its process is no longer possible [1][2][3][4]. Patients facing unbearable suffering from terminal illnesses experience multiple physical, psychosocial, and cognitive processing problems at the end-of-life stage [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…As part and parcel of palliative care, end-of-life (EOL) care involves care being given in the last part of a patient's life, typically in the last few months, depending on the primary diagnosis and clinical course [5]. Global interest in EOL care is growing, for compelling demographic and epidemiological reasons [1,2]. The population of the world is ageing and the number of people dying each year is set to rise [1,6].…”

Section: Introductionmentioning

confidence: 99%

“…Based on the existing literature [1][2][3][4][5][6][7][8], Western and non-Western countries are found in different views: Religious and spiritual expectations surrounding death; laws and opinions about euthanasia. In addition, the practices and beliefs of healthcare professionals of EOL care are also framed by culture [1,2]. In 2018, Korea legislated the Well-dying Act [4].…”

Section: Introductionmentioning

confidence: 99%

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Hospital Nurses’ Perception of Death and Self-Reported Performance of End-of-Life Care: Mediating Role of Attitude towards End-of-Life Care

et al. 2020

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Few studies have explored how nurses in acute care hospitals perceive and perform end-of-life care in Korea. Therefore, this study aimed to evaluate the influence of nurses’ perceptions of death on end-of-life care performance and analyze the mediating role of attitude towards end-of-life care among hospital nurses. This cross-sectional study included a total of 250 nurses who have had experience with end-of-life care from four general hospitals in Korea. We used the Korean validated tools with the View of Life and Death Scale, the Frommelt Attitudes Toward Care of the Dying (FATCOD) scale, and the performance of end-of-life care. Hierarchical linear regression and mediation analysis, applying the bootstrapping method. The results of hierarchical linear regression showed that nurses’ positive perceptions of death and attitude towards end-of-life care were significantly associated with their performance of end-of-life care. A mediation analysis further revealed that nurses’ attitude towards end-of-life care mediates the relationship between the perceptions of death and performance of end-of-life care. Our findings suggest that supportive and practical death educational programs should be designed, based on nurses’ professional experience and work environment, which will enable them to provide better end-of-life care.

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“…[1][2][3][4][5][6][7] However, nursing home staff lack training in primary palliative care and nursing home residents do not have consistent access to palliative care specialists. [8][9][10][11][12][13] Attention to palliation is a particularly important part of efforts to reduce potentially avoidable hospitalizations of long-stay nursing facility residents, with potential to decrease transfers related to in adequate symptom management and promote efforts to provide goal-concordant treatment in place. When increased management of acute and chronic conditions provided in place, it is essential to ensure there are no unintended harms related to unmet palliative care needs such as symptom management.…”

Section: Introductionmentioning

confidence: 99%

The Role of the Palliative Care Registered Nurse in the Nursing Facility Setting

Hickman

Parks

Unroe

et al. 2020

J Hosp Palliat Nurs

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There is a growing recognition of significant, unmet palliative care needs in nursing facilities, yet limitations in the workforce limit access to palliative care services. Attention to palliation is particularly important when there are efforts to reduce hospitalizations to help ensure there are no unintended harms associated with treating residents in place. A specialized palliative care Registered Nurse (PCRN) role was developed as part of the OPTIMISTIC program, a federally funded project to reduce potentially avoidable hospitalizations. Working in collaboration with existing clinical staff and medical providers, the PCRN focuses on managing symptoms, advance care planning, achieving goal concordant care, and promoting quality of life. The PCRN serves as a resource for families through education and support. The PCRN also provides education and mentorship to staff to increase their comfort, knowledge, and skills with end-of life care. The goal of this article is to provide an overview of the PCRN role and its implementation in nursing facilities, and describe core functions that are transferrable to other contexts.

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The Hospice and Palliative Care Advanced Practice Registered Nurse Workforce

Cited by 22 publications

References 13 publications

Policy Changes Key To Promoting Sustainability And Growth Of The Specialty Palliative Care Workforce

Policy Changes Key To Promoting Sustainability And Growth Of The Specialty Palliative Care Workforce

Hospital Nurses’ Perception of Death and Self-Reported Performance of End-of-Life Care: Mediating Role of Attitude towards End-of-Life Care

The Role of the Palliative Care Registered Nurse in the Nursing Facility Setting

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