Community palliative care clinical nurse specialists: a descriptive study of nurse-patient interactions.
BACKGROUND
With an ageing population and changes to the UK process of commissioning health-care services, it is important that the role of the community palliative care clinical nurse specialist (CPC-CNS) is better understood.


OBJECTIVE
This study aimed to describe CPC-CNS activities during interactions with patients.


METHODS
Four CPC-CNSs were observed and audio-recorded during interactions with 34 patients. The data was assessed qualitatively using thematic analysis.


RESULTS
An enormous breadth of activities were observed, within a framework of assessment, planning, intervention, and evaluation. Cross-cutting themes were real-time decision making, leadership, ability to respond to and coordinate complex and varied situations, and communication techniques. Data saturation was not achieved.


CONCLUSIONS
CPC-CNSs provide multifaceted care, requiring wide-ranging knowledge to enable them to act as liaison points in a complex health service, respond independently to the fluctuating needs of patients, and provide effective advance care planning, particularly to those with advanced disease, multi-morbidity, and frailty.
Research Fellow, Epidemiology and Cancer Statistics Group, Department of Health Sciences, Seebohm Rowntree Building, University of York, York, YO10 5DD, England.
Debra
D
Howell
Senior Research Fellow, Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, Faculty of Medicine and Health Sciences, University of Nottingham, England.
Beth
B
Hardy
Community Specialist Palliative Care Nurse, The Lodge, St Leonards Hospice, York, England.
Caroline
C
Boyd
Nurse Consultant in Adult Palliative Care, South Tees Hospitals NHS Foundation Trust, England.
Chris
C
Ward
Professor of Epidemiology, Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, England.
Eve
E
Roman
Professor of Palliative Medicine, Hull York Medical School, University of Hull, England.
Miriam
M
Johnson
D003152:Community Health Nursing; D009723:Nurse-Patient Relations; D009740:Nursing Staff; D010166:Palliative Care; D013041:Specialties, Nursing; D006113:United Kingdom