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Oncology Nurses' Perceptions of Nursing Roles and Professional Attributes in Palliative Care

Carol Pavlish
Lyn Ceronsky
CJON 2009, 13(4), 404-412 DOI: 10.1188/09.CJON.404-412

Managing symptoms, providing information, and supporting families as well as patients are key aspects of palliative care. However, palliative care definitions and perspectives vary widely in clinical practice and often do not align with palliative care organizations' perspectives. Definitional discrepancies may result in delayed referrals and role confusion, which often limit the effectiveness of palliative care programs and contribute to gaps in care and services for patients and their families. The aim of this research study was to explore oncology nurses' perspectives of palliative care through narrative analysis of participants' descriptions of life experiences. Studying nurses' perceptions of their roles in palliative care offers an opportunity to examine and improve clinical practice. Nine focus groups were conducted with 33 oncology nurses in three medical centers in the midwestern region of the United States. Researchers inductively coded research text within each focus group session, sorted across sessions using Atlas.ti 5.2 software, and then applied categorical-content narrative analysis. Findings revealed five primary nursing roles: teaching, caring, coordinating, advocating, and mobilizing. In all five roles, seven professional attributes were described: clinical expertise, honesty, family orientation, perceptive attentiveness, presence, collaboration, and deliberateness. Integrating palliative care standards into role and attribute development and working with palliative care specialty teams are suggested.


American Academy of Hospice and Palliative Medicine. (2006). <i>Position statement on clinical practice guidelines for quality palliative care.</i> Retrieved July 12, 2008, from <a target="_blank" href='http://www.aahpm.org/positions/quality.html'>http://www.aahpm.org/positi...

American Nurses Association. (2001). <i>Code of ethics for nurses with interpretive statements.</i> Silver Spring, MD: Author.

Bliss, J., Cowley, S., & While, A. (2000). Interprofessional working in palliative care in the community: A review of the literature. <i>Journal of Interprofessional Care</i>, 14(3), 281-290.

Center to Advance Palliative Care. (2005). <i>The case for hospital-based palliative care.</i> Retrieved July 12, 2008, from <a target="_blank" href='http://www.capc.org/support-from-capc/capc_publications/making-the-case....

Davies, B., & Oberle, K. (1990). Dimensions of the supportive role of the nurse in palliative care. <i>Oncology Nursing Forum</i>, 17(1), 87-94.

Davies, B., & Oberle, K. (1992). Support and caring: Exploring the concepts. <i>Oncology Nursing Forum</i>, 19(5), 763-767.

Degner, L., Gow, C., & Thompson, I. (1991). Critical nursing behaviors in care for the dying. <i>Cancer Nursing</i>, 14(5), 246-253.

End-of-Life Nursing Education Consortium. (2005). <i>Promoting palliative care in oncology nursing training program.</i> Washington, DC: American Association of Colleges of Nursing.

Froggatt, K.A., & Hoult, L. (2002). Developing palliative care practice in nursing and residential care homes: The role of the clinical nurse specialist. <i>Journal of Clinical Nursing</i>, 11(6), 802-808.

Gadow, S. (1985). Nurse and patient: The caring relationship. In A. Bishop & J. Scudder (Eds.), <i>Caring, curing, coping</i> (pp. 31-43). Tuscaloosa, AL: University of Alabama Press.

Georges, J., Grypdonck, M., & De Casterle, B. (2002). Being a palliative care nurse in an academic hospital: A qualitative study about nurses' perceptions of palliative care nursing. <i>Journal of Clinical Nursing</i>, 11(6), 785-793.

Hospice and Palliative Nurses Association. (2007). <i>Hospice and palliative nursing: Scope and standards of practice.</i> Washington, DC: American Nurses Association.

Ingvarson, L. (1998). Professional development as the pursuit of professional standards: The standards-based professional development system. <i>Teaching and Teacher Education</i>, 14(1), 127-140.

Johnston, B. (2005). Introduction to palliative care: Overview of nursing developments. In J. Lugton & R. McIntyre (Eds.), <i>Palliative care: The nursing role</i> (pp. 1-32). New York: Elsevier.

Johnston, B., & Smith, L. (2006). Nurses' and patients' perceptions of expert palliative nursing care. <i>Journal of Advanced Nursing</i>, 54(6), 700-709.

Lieblich, A., Tuval-Mashiach, R., & Zilber, T. (1998). <i>Narrative research: Reading, analysis, and interpretation.</i> Thousand Oaks, CA: Sage.

Luker, K.A., Austin, L., Caress, A., & Hallett, C. (2000). The importance of ‘knowing the patient’: Community nurses' constructions of quality in providing palliative care. <i>Journal of Advanced Nursing</i>, 31(4), 775-782.

Meghani, S. (2004). A concept analysis of palliative care in the United States. <i>Journal of Advanced Nursing</i>, 46(2), 152-161.

Mok, E., & Chiu, P. (2004). Nurse-patient relationships in palliative care. <i>Journal of Advanced Nursing</i>, 48(5), 475-483.

Morrison, R.S., Penrod, J., Cassel, B., Caust-Ellenbogen, M., Litke, A., Spragens, L., et al. (2008). Cost savings associated with US hospital palliative care consultation programs. <i>Archives of Internal Medicine</i>, 168(16), 1783-1790.

National Comprehensive Cancer Network. (2008). <i>Clinical practice guidelines in oncology™: Palliative care.</i> Retrieved November 5, 2008, from <a target="_blank" href='http://www.nccn.org'>http://www.nccn.org</a>

National Consensus Project. (2009). <i>Clinical practice guidelines for quality palliative care.</i> Retrieved June 24, 2009, from <a target="_blank" href='http://www.nationalconsensusproject.org'>http://www.nationalconsensuspro...

National Quality Forum. (2006). <i>A national framework and preferred practices for palliative and hospice care quality.</i> Retrieved February 12, 2008, from <a target="_blank" href='http://www.qualityforum.org/pdf/reports/palliative/txPHreportPUBLIC01-29...

Oncology Nursing Society. (2007). <i>Oncology Nursing Society and Association of Oncology Social Work joint position on end-of-life care.</i> Retrieved November 5, 2008, from <a target="_blank" href='http://www.aosw.org/docs/pos-ons.pdf'>www.aosw.org/docs/pos-ons.pdf</a>

Pavlish, C., & Ceronsky, L. (2007). Oncology nurses' perceptions about palliative care. <i>Oncology Nursing Forum</i>, 34(4), 793-800.

Perry, B. (1998). Beliefs of eight exemplary oncology nurses related to Watson's nursing theory. <i>Canadian Oncology Nursing Journal</i>, 8(2), 97-101.

Philip, J., & Komesaroff, P. (2006). Ideals and compromises in palliative care. <i>Journal of Palliative Medicine</i>, 9(1), 19-25.

Ronaldson, S., & Devery, K. (2001). The experience of transition to palliative care services: Perspectives of patients and nurses. <i>International Journal of Palliative Nursing</i>, 7(4), 171-177.

Vachon, M.L. (2001). The nurse's role: The world of palliative care nursing. In B. Ferrell & N. Coyle (Eds.), <i>Textbook of palliative care</i> (pp. 647-662). New York: Oxford University Press.

Watson, J. (1988). <i>Nursing: Human science and human care.</i> New York: National League for Nursing.

World Health Organization. (2002). <i>National cancer control programmes: Policies and managerial guidelines.</i> Geneva, Switzerland: World Health Organization.