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Palliative care is the physical, social, emotional, and spiritual care of people with a life-limiting illness (Palliative Care Subcommittee, 2007). As a health care service, palliative care advocates for a holistic multidisciplinary approach. While service delivery is certainly multidisciplinary, whether health professionals working in New Zealand palliative care services practice collaboratively, and in what form that collaboration takes, is unknown. Collaborative practice can be difficult to achieve, as traditionally trained health professionals are more accustomed to working alongside each other, rather than together (Herbert, 2005; Herbert et al., 2007). Gaining further knowledge about what is occurring in practice is important when, driven by international workforce shortages and an increasing complexity of health care, the World Health Organisation (WHO) (WHO & Health Professions Network Nursing and Midwifery Office: Department of Human Resources for Health, 2010) has called for interprofessional education and collaborative practice across all areas of health care.Glaserian grounded theory methodology has been used to examine the area of interest which is, ‘What is the main concern of health professionals working collaboratively in palliative care (with colleagues and patients) and how do they manage that?’ A total of 25 interviews were undertaken with 23 participants, across professional disciplines, working in palliative care services within the North Island of New Zealand. Through an iterative process of constant comparative analysis and conceptualisation, using memoing, key concepts, and abstracting categories, a theory emerged. The theory of Sharing Time explained the social process of how health professionals working collaboratively in palliative care facilitated collaboration, while managing their main concern. Sharing Time is both an interactive participatory process and an outcome.The main concern of possessorship, is defined as having possession of a tangible commodity or having a need to have possession of an intangible commodity, that has the potential to impact patient care when not shared. Sharing Time occurs when health professionals purposefully make time, take time, find time, and spend time in their workday for and with each other, to share further, and facilitate collaboration. Sharing Time occurs through purposeful connecting and finding common ground. Integrated by reciprocity this theory is mutually beneficial to all involved as there is an exchange of a commodity, such as equipment or information, which improves patient care.This research also discovered that health professionals Sharing Time are facilitating collaboration by situating this strategy in a middle ground. Moving outside of this middle ground, where there is too much or too little Sharing Time, continues the main concern of possessorship rather than manages it, which adds barriers to collaboration. The theory of Sharing Time has potential value for all health professionals working in palliative care, as it facilitates collaboration and promotes further sharing. Collaboration and managing possessorship promotes a safer work environment.
Author supplied keywords: Sharing time; Possessorship; Hospice; Palliative care; Collaboration.
Collaborative Practice in Palliative Care explores how different professions work collaboratively across professional, institutional, social, and cultural boundaries to enhance palliative care. Analysing palliative care as an interaction between different professionals, clients, and carers, and the social context or community within which the interaction takes place, it is grounded in up-to-date evidence, includes global aspects of palliative care and cultural diversity as themes running throughout the book, and is replete with examples of good and innovative practice. Drawing on experiences from within traditional specialist palliative care settings like hospices and community palliative care services, as well as more generalist contexts of the general hospital and primary care, this practical text highlights the social or public health model of palliative care. Designed to support active learning, it includes features such as case studies, summaries, and pointers to other learning resources. This text is an important reference for all professionals engaged in palliative care, particularly those studying for post-qualification programmes in the area.
As humanitarian aid organizations have evolved, there is a growing recognition that incorporating palliative care into aid efforts is an essential part of providing the best care possible. A Field Manual for Palliative Care in Humanitarian Crises represents the first-ever effort at educating and providing guidance for clinicians not formally trained in palliative care in how to incorporate its principles into their work in crisis situations. Written by a team of international experts, this pocket-sized manual identifies the needs of people affected by natural hazards, political or ethnic conflict, epidemics of life-threatening infections, and other humanitarian crises. Later chapters explore topics including pain management, skin conditions, non-communicable diseases, palliative care emergencies, the law and ethics of end of life care, and more. Concise and highly accessible, this manual is an ideal educational tool pre-deployment or during fieldwork for clinicians involved in planning and providing humanitarian aid, local care providers, and medical trainees.
Communication in Palliative Nursing unites complementary work in communication studies and nursing research to present a theoretically grounded curriculum for teaching palliative care communication to nurses. The chapters outline the COMFORT curriculum, comprised of these elements: Communication, Orientation and opportunity, Mindful presence, Family, Openings, Relating, and Team communication. Central to this curriculum is the need for nurses to practice self-care. Based on a narrative approach to communication, which addresses communication skills development holistically, this volume teaches nurses to consider a holistic model of communication that aligns with the holistic nature of palliative care. This work moves beyond the traditional and singular view of the nurse as patient and family teacher, to embrace more complex communication challenges present in palliative care -- namely, providing care and comfort through communication at a time when patients, families, and nurses themselves are suffering. In addition to collaborating with physicians, the nurse's role involves speaking with patients and families after they have received bad news and often extends to discussions of spiritual and religious concerns. This book covers communication theory, clinical tools, and teaching resources to help nurses enhance their own communication and create comfort for themselves, as well as for patients and their families.
Participatory research is a relatively new method of researching practice especially within palliative care. It differs from other methodologies in that there is an expectation of action within the research process. The values that underpin participatory research are collaboration, empowerment, and reflection. In the current climate of collaboration and working with people in healthcare, participatory research methods are gaining increasing interest when there is a desire to bring about change. Organisational change is becoming an important focus as we look at ways of not only reducing costs but at the same time improving quality of care. While palliative care puts the patient and family at the centre, Participatory Research in Palliative Care discusses a new research methodology that puts practitioners at the heart of the research process as collaborators who work together with researchers to resolve problems in practice. Divided into three sections, it provides theoretical groundings of action research, a greater focus on exemplars from studies within palliative care, and discusses prominent issues when using such a methodology. All three sections are illustrated by an action research study undertaken by the author within a palliative care setting. Participatory Research in Palliative Care is written by international, multi-disciplinary authors who explore a collaborative approach to embark on research. It will appeal to health and social care professionals, academics undertaking research within palliative care, and the management of organisations where people with end of life care needs are cared for, including long-term care homes.
"The first edition of Communication in Palliative Nursing was published in 2012 and became the market leader for nurses wanting to learn more about how to improve and teach palliative care communication. For the last 8 years, it has remained the only text solely focused on the vital role of nurses in palliative care. During this time, the COMFORT model was taught to nurses nationwide who brought the curriculum back to their own institutions and taught components of the model to more than 10,000 healthcare providers across the United States (Wittenberg, Ferrell, Goldsmith, Ragan, & Buller, 2017). Numerous journal articles and research studies have been produced to highlight the principle components of the COMFORT model and test its effectiveness among healthcare audiences across a variety of clinical and educational settings. Through this all, as the model was disseminated to clinical audiences of bedside nurses, nurse leaders, nursing students, and interprofessional learners, feedback was captured about COMFORT. Comments revealed major components of the model that were working and weren't working for the nurses and other healthcare providers who utilized the strategies with patients and families, and began using curriculum tools for teaching and integrating palliative care communication instruction. So, much like the model's grounding in a transactional communication approach, which relies on the co-created interaction between parties, it was clear that the COMFORT model was also ebbing and flowing and had to change. More importantly, palliative care has been growing, changing, expanding, and becoming more sophisticated, more wide-spread! Now more than ever before, palliative care is provided in the home, clinic, or inpatient setting and serves patients who are seriously or chronically ill and their families. It became evident that in order to continue improvements to the model and to keep up with the changing landscape of palliative care and palliative patient populations, a new edition was necessary. Before we highlight the changes, it is never too early to overstate our steadfast commitment to the following principles: We believe that communication research and theory can shape palliative care practices, providing tools for a variety of contexts. We believe that palliative care, offering compassionate, holistic treatment for patients and their families, will not be possible without caring for the entire person (body and mind). We believe that communicating about palliative care must begin at diagnosis of serious illness, not just at end-stages. We believe in a patient-centered approach to communication that emphasizes the role of the family caregiver in the illness trajectory. We believe that intentional communication emphasizing team processes among physicians, nurses, social workers, chaplains, and other healthcare professionals improves palliative care practice. We believe that palliative care should be introduced early in the communication education of all health professionals. We believe that education about palliative care and communication must extend to patients and families who can then advocate for and partner more productively in such services. We believe that communication with the family caregiver is essential for the treatment of pain and symptom management. We believe that frequent conversations are needed across the disease/care trajectory, as patients and families encounter ongoing points of decision-making"--
Teamwork is a complex but essential component of palliative care. The needs of people diagnosed with life threatening disease will vary greatly over time, and it is rarely possible for just one professional to be able to provide adequate care. In order to ensure an holistic approach, the whole multi-disciplinary team must be involved. Inevitable questions arise from such an approach, and this book seeks to address these. How does a team come into being? What different formats are there? How might the patient contribute to the effectiveness of their care and the way in which the team operates? What are the difficulties and frustrations encountered in developing and maintaining such teams? What models of working and styles of leadership have developed? How are power and authority handled within the team setting? The importance of team building, training, support, attention to group process, and stress management to protect the mental health of the team are explored. The ethical issues inherent in palliative care such as consent, autonomy, confidentiality, decision making within teams, and the legal implications of such are also discussed. The book concludes with one important question - do we know if teams are the most effective way of providing care? This book addresses key issues surrounding the role of the team in palliative care, and is an essential guide to reappraising the importance of collaborative teamwork, and enhancing understanding of existing team structures.
Note to Readers: Publisher does not guarantee quality or access to any included digital components if book is purchased through a third-party seller. A focus on intentional communication, team building, and relational maintenance This text is designed to help form and maintain palliative care teams that survive and thrive. Whether you are starting a new team or hoping to help an existing team, this text addresses aspects of team players, leadership, meetings, organizational culture, and self- and team-care through a combination of empirical data and real voices from healthcare professionals in palliative care practice. By focusing on the individual professional in relation to team health and success, this text shows how to develop high-quality, high-performing palliative care teams. Perfect for students and working professionals, this text is useful at any time in your career or your team’s development. It explores the types of providers involved in palliative care, their roles, possible conflicts, and the opportunity to amplify their work as a team while overcoming the stigma that may be attached to palliative care. This book focuses on the foundational role of communication in leadership, team building, and the delivery of patient care. Designed to provide workable solutions to challenges such as poor team design, siloing, and faulty communication, it provides suggestions that can be implemented immediately by your palliative care team. This focus allows healthcare professionals who are passionate about palliative care to grow into high-functioning teams with a focus on excellent patient care. Key Features: Satisfactory and unsatisfactory palliative care experiences Stories from nurses, social workers, chaplains, physicians, pharmacists, executives, patients, and families Pearls From the Field: Provider and team takeaways Best practices of team leaders Tips for individuals and palliative care teams to communicate with other providers, departments, and senior leadership Discussions on how to improve short-term and long-term functionality Outlines to use as predictors of burnout for palliative care professionals and teams Self-care and team-care suggestions A combination of recent research and theory in an accessible writing style Includes podcasts, videos, and case study and self-care plan supplements
Palliative care is the interdisciplinary specialty focused on improving quality of life for people with serious illness and their families. This interdisciplinary care is provided by doctors, nurses, social workers, chaplains and others who work together with the patient's other doctors to provide an extra layer of support. Such care is appropriate for people at any age and at any stage in a serious illness, and can be provided together with curative treatment to address clinical, emotional, psychosocial and spiritual concerns of the patient and their family. To better understand how the principles of palliative care can be integrated into the overall provision of care and services to those facing serious illness, the Roundtable on Quality Care for People with Serious Illness held a public workshop in April 2017. This publication summarizes the presentations and discussions from the workshop.