Collaborative Practice: a Study in Bridging the Gap to Transform the Delivery of Specialist Palliative Nursing Care in Residential Aged Care Facilities

Abstract

This paper documents a practice development initiative with the aim of formulating a rationale for the professional practice development of a relatively recently conceived nursing initiative; that of a Palliative Care Liaison Nurse (PCLN) role. The project involved conducting an inquiry through a search of the literature with the aim of discovering ways to articulate, then develop, the role to meet the needs of elderly people living in Residential Aged Care Facilities (RACFs), their family and the whanau (whanau is a maori term specific to describing maori family's). The paper initially explores the concept of liaison roles globally, to consider how this role might be located as an interagency position between palliative care and aged care within the context of Aotearoa/New Zealand. The paper then reveals the perceived skills and personal attributes required by a person in the PCLN role that the author, drawing from personal and professional experience of having been appointed to this position, considers are necessary to effectively manage the diverse dimensions of this role. Bridging the gap is a key role discussed which centres on the capacity to organise and present an effective education program while supporting, encouraging and role modeling for staff providing the day to day nursing care. This role involves practice wisdom and advocating for change and tolerance within everyday practice. An example of this dimension is discussed in depth, because the researcher considers that through staff working together, they can effectively bridge the knowledge-practice gap which exists between specialist palliative and gerontological nursing care. Reflecting on my experience in establishing this role has helped me to evaluate and present a case for promoting and establishing the PCLN role. The desired goal of caring for the dying elderly in RACFs being integrated, cost-effective, and creatively sustained at an acceptable level for the patient, their family or whanau and for staff.