Supporting nurses to provide palliative care
What is palliative care?
Palliative care is a holistic approach to care that improves the quality of life for patients facing a life-threatening or life-limiting illness. As providers, we know through research that patients suffering from a non-curable illness want honest and timely information about their condition including treatment options. They want to know their physical symptoms will be managed to relieve suffering, and they want to die in a place of their choice.
Palliative Care Nursing Practice Committee at HHS
Nursing is a pivotal role in achieving patient goals and supporting family members. In 2016, the Director of Oncology Critical Care & Palliative Care and Interprofessional Practice Chief, established the HHS Palliative Care Nursing Practice Committee to support and enhance nursing practice in order to deliver a positive experience for patients and families.
The committee is co-chaired by Charissa Cordon, Chief of Nursing Practice and Cathy Reis, Clinical Nurse Specialist with the Juravinski Hospital and Cancer Centre Palliative Care Team. The committee meets monthly and is comprised of nursing representation from across HHS sites, including nurse leaders, advanced practice nurses, point of care nurses, the office of ethics, and a patient/family advisor.
The committee has made efforts to understand the knowledge, strengths and gaps of nursing at HHS to develop educational strategies and a work plan prioritizing the needs of various HHS nursing groups.
In addition to staff input, a family advisor has been an active member of this committee. Based on her experience with a loved one, she has helped us understand the importance of early identification of supports that would assist in enhancing quality of life and open, clear communication between staff, physicians, patients and family.
“providing palliative care services alongside disease specific treatment is becoming more recognized as an approach to care that can improve the quality of a person’s life”
A work in progress
The committee aims to bridge the gap between nursing education and nursing practice and ultimately raise the profile of palliative care nursing across HHS. They have begun implementing education strategies in addition to supporting several initiatives at HHS. Work to date includes:
• The development of an education module on palliative care that has been incorporated into the HHS Health Professional Orientation (HPO) for all new staff members.
• The development of an HHS Palliative Care Nursing site with nursing specific resources, patient information material and nursing education opportunities.
• Embedding knowledge of a palliative care philosophy and care competencies into targeted nursing orientation programs such as oncology, intensive care, and at select program-specific annual skills update.
• Development of learning pathways and implementing symptom management guides in St Peter’s Hospital specialized palliative care unit.
• The committee recognizes the importance of clear, quality conversations with patients and families which leads to creating care plans that align with a patient’s wishes and values. Several committee members had an opportunity to attend an education workshop led by members of the Serious Illness Conversation Program in an effort to build training skills and mentor others.
• Member contribution to the development of the Ontario Hospice Palliative Care Standards.
• Provincial recognition and award for best oral presentation at the Hospice Palliative Care Ontario Conference in April 2018.
Improving quality of life
As co-chair of the HHS Quality End of Life Steering Committee and Clinical Ethicist for HHS, Sandra Andreychuk has observed a shift in the perception of living with a non-curable illness. The notion of providing palliative care services alongside disease specific treatment is becoming more recognized as an approach to care that can improve the quality of a person’s life.
Teams are beginning to appreciate that all health care professionals have a role in assisting patients and families in delivering care plans that align with a patient’s wishes and values. The Nursing Palliative Care Practice Committee has taken the lead on identifying how best to build capacity among their discipline to facilitate this across units at HHS.
As HHS’ Palliative Care Physician Dr. Joshua Shadd would say, “palliative care is everybody’s business” and the Palliative Care Nursing Practice Committee is making that happen.