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Nursing the dying within a generalist caseload: a focus group study of district nurses

Nursing the dying within a generalist caseload: a focus group study of district nurses
Nursing the dying within a generalist caseload: a focus group study of district nurses
Background: Community nurses (members of UK District Nursing teams) have a key role in the provision of palliative care in the community in the UK. However, their views about delivering palliative care within their generalist workload have not been assessed.
Objectives: To explore community nurses’ perceptions of their palliative care role, and their provision of such care within the context of their wider generalist workload.
Design: Focus group study.
Setting: Four Primary Care Trusts in London, UK.
Participants: A purposive sample of 51 community nurses.
Methods: Nine focus groups (four to seven participants in each) were conducted between 2003 and 2004. Data were analysed using the framework approach.
Results: We identified five broad themes. Community nurses felt they had a central role in the provision of palliative care to patients at home. Many felt this role was not recognised by other health care professionals and managers. Palliative care was identified as unpredictable and time-consuming within a pressurized context characterised by staff shortages and consequent lack of time. Whilst rewarding, palliative care took its toll on nurses’ emotions, compounded by a perceived lack of formal support. Finally, undertaking palliative within a generalist workload created additional pressures for community nurses.
Conclusions: The integration of palliative care into routine generalist caseloads generated workload stresses in time and emotion. Community nurses felt their palliative care role and its impact on workload was not adequately acknowledged. Palliative care specific support mechanisms and ways of working may be necessary to meet patients’ and professionals’ expectations of effective, compassionate care at the end of life.
district nursing, community nursing, focus groups, nurse roles, palliative care, qualitative approaches
0020-7489
1470-1478
Burt, Jenni
af1903e7-2bb8-464d-8e82-ec1076fdbb2e
Shipman, Cathy
4508f5e7-c5b1-4955-af5d-431878d74e1a
Addington-Hall, Julia
87560cc4-7562-4f9b-b908-81f3b603fdd8
White, Patrick
aa8d0bb0-0a13-4c57-8b3b-e8fa19b46b93
Burt, Jenni
af1903e7-2bb8-464d-8e82-ec1076fdbb2e
Shipman, Cathy
4508f5e7-c5b1-4955-af5d-431878d74e1a
Addington-Hall, Julia
87560cc4-7562-4f9b-b908-81f3b603fdd8
White, Patrick
aa8d0bb0-0a13-4c57-8b3b-e8fa19b46b93

Burt, Jenni, Shipman, Cathy, Addington-Hall, Julia and White, Patrick (2008) Nursing the dying within a generalist caseload: a focus group study of district nurses. International Journal of Nursing Studies, 45 (10), 1470-1478. (doi:10.1016/j.ijnurstu.2008.01.003).

Record type: Article

Abstract

Background: Community nurses (members of UK District Nursing teams) have a key role in the provision of palliative care in the community in the UK. However, their views about delivering palliative care within their generalist workload have not been assessed.
Objectives: To explore community nurses’ perceptions of their palliative care role, and their provision of such care within the context of their wider generalist workload.
Design: Focus group study.
Setting: Four Primary Care Trusts in London, UK.
Participants: A purposive sample of 51 community nurses.
Methods: Nine focus groups (four to seven participants in each) were conducted between 2003 and 2004. Data were analysed using the framework approach.
Results: We identified five broad themes. Community nurses felt they had a central role in the provision of palliative care to patients at home. Many felt this role was not recognised by other health care professionals and managers. Palliative care was identified as unpredictable and time-consuming within a pressurized context characterised by staff shortages and consequent lack of time. Whilst rewarding, palliative care took its toll on nurses’ emotions, compounded by a perceived lack of formal support. Finally, undertaking palliative within a generalist workload created additional pressures for community nurses.
Conclusions: The integration of palliative care into routine generalist caseloads generated workload stresses in time and emotion. Community nurses felt their palliative care role and its impact on workload was not adequately acknowledged. Palliative care specific support mechanisms and ways of working may be necessary to meet patients’ and professionals’ expectations of effective, compassionate care at the end of life.

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More information

Published date: October 2008
Keywords: district nursing, community nursing, focus groups, nurse roles, palliative care, qualitative approaches

Identifiers

Local EPrints ID: 64577
URI: https://eprints.soton.ac.uk/id/eprint/64577
ISSN: 0020-7489
PURE UUID: a7b93da9-36db-410c-9788-737d5924a9a6

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Date deposited: 05 Jan 2009
Last modified: 13 Mar 2019 20:21

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