Written by Melissa Bruno, Nurse Consultant and Palliative Care Link Nurse Coordinator, Northern Adelaide Palliative Service, Northern Adelaide Local Health Network.
Despite over half of all deaths in Australia occurring in hospitals, nurses are often not equipped with the knowledge, skills and confidence to care for someone who is dying . Nurses often feel they don’t know what to say to patients and families and feel they don’t have the confidence to have conversations about dying. And yet nurses are often the first to recognise a patient is deteriorating. They spend the most time with patients along their long illness journey, often in the most intimate of ways.
With a limited number of specialised inpatient palliative care beds and limited capacity of the palliative care consult team in hospitals to see every dying patient, there is a need to get this area of practice right.
The Palliative Care Link Nurse Program was developed to explore nurses’ attitudes towards death and dying, and through support and mentorship, give them the skills and knowledge to feel more comfortable to care for dying patients. Link nurses complete quality improvement activities such as Death Audits identifying areas of practice that can be improved on whilst also recognising what was done well. They also provide education to their colleagues on end-of-life care and share what they have learnt and act as a link between the specialised palliative care team and the general wards.
The program has resulted in exciting new initiatives such as a traineeship position with the community palliative care team and palliative care unit where link nurses can apply to work with the service for 6 months to then bring that knowledge and experience back to their clinical areas. It has also shown to be a potential source of future recruitment to the specialist palliative care team and has resulted in capacity building across the hospital.
The initial research showed that nurses involved in the program reported an increased level of knowledge and confidence in caring for dying patients and their families. The next step is to do some further research to gain insight into consumers experience of end-of-life care in the hospital setting to help guide the development of the palliative care link nurse program.
- Australian Commission on Safety and Quality in Health Care. Safety and quality end-of-life care in acute hospitals: a background paper. Sydney: ACSQHC, 2013. Accessed 15 December 2022.
Links for readers
Bruno M. The introduction of a palliative care link nurse programme to improve nurses’ attitudes, knowledge and confidence in providing end-of-life care in an acute care setting. Int J Palliat Nurs. 2022 Nov 2;28(11):540-545. doi: 10.12968/ijpn.2022.28.11.540. PMID: 36417283.
- End-of-Life Essentials modules: https://www.endoflifeessentials.com.au
Hear more from Melissa Bruno about the Palliative Care Link Nurse Program at the RePadd Seminar Series: