Continuing our series to celebrate the International Year of the Nurse and Midwife 2020 and the benefits that nursing and midwifery bring to the health of the global population.
To mark this world first, the European Association for Palliative Care (EAPC) is delighted to publish a special series of 12 monthly posts to honour the work of nurses who work in palliative care and draw attention to several issues that are linked to this crucial workforce. Today, we hear from Catherine Walshe, Professor of Palliative Care at the International Observatory on End of Life Care at Lancaster University, United Kingdom, and Editor-in-Chief of Palliative Medicine, the official research journal of the EAPC.
Their eyes glaze over. They find it complicated to understand. They don’t know where to find access to relevant information. Yep. I’m talking about research. And more so I’m talking about nurses and research. As a nurse myself, and an educator, I feel able to give myself and my profession a steely gaze and acknowledge that we haven’t done as good a job as possible in helping nurses to understand how important research is, either as producers or consumers of research. Yet, in this International Year of the Nurse and Midwife, we clearly recognise that nursing is critically important to palliative care. Nurses are usually the most common healthcare professionals providing care and they likely have most contact with patients. Can we be assured that the care that they give is research based, where possible, in good evidence? In my view, probably not, as research is, for many nurses, not a core component of their educational preparation or ongoing development. There is little funding or support for them to conduct research, and typical career pathways or job plans don’t encourage research activity. There are notable exceptions such as the National Institute for Health research leader programme and clinical researcher development awards in my own country, the UK, but I think it fair to say that research remains peripheral to much nursing practice.
And yet, there is great and influential nursing research out there that should guide our nursing practice. Sometimes we likely don’t recognise that it is nursing research or research about nursing practice. So, for example, do you recognise that the core component of the ENABLE trial of early palliative care is nurse coaching? Sometimes it is important that we look at reviews of multiple studies to guide our practice, such as this review that clearly demonstrates that interventions by specialist nurses in palliative care are effective in reducing healthcare resource use such as admissions, re-hospitalization, length of stay and healthcare costs. Research with nurses can tell us the characteristics that contribute to being ‘brilliant’ at providing palliative care through anticipation, commitment, and flexibility. Research can also indicate that perhaps some nurse interventions such as ‘nurse champions’ for palliative care in hospitals may not make a difference, from the point of view of bereaved relatives and we should rethink particular ways of providing care.
What nursing research in palliative care often contributes is a real focus on the personal and interpersonal aspects of care for people who are dying – areas that we know are critical to care provision, and how people experience care.
We need a multi-pronged approach to ensure that such nurse-led and influenced research is common, published, read, and incorporated into practice. This is clearly a complex area, not just within palliative care. However, we can ensure that understanding and using research is at the heart of specialist palliative care nurse preparation. We can create time within palliative care nursing posts for research activity, and ensure that nurses are represented in palliative care research teams. We should help prepare nurses at PhD level so that they can become our nurse research leaders in palliative care for the future.
I started my nursing career in 1983 in a nurse degree programme where research was central to the education we received (thank you Manchester University), and that experience shaped my research career. Let’s make it possible for many more nurses.
Celebrate the International Year of the Nurse and Midwife 2020 on the EAPC blog #nurses2020 #midwives2020 View the series so far here and join us in April when Marius Čiurlionis, Head of a Nursing, Palliative Medicine and Social Care Clinic in Lithuania, will be our guest writer.
- Find out more about research and training opportunities at the International Observatory on End of Life Care.
- See Catherine’s profile here.
- Follow Catherine on Twitter @cewalshe
- Read Palliative Medicine‘ Editor’s choice’ posts on the EAPC blog.