Palliative care needs everyone on board, says Queensland nurse Lynn Knowles.
“We have to bring everyone together in collaboration and network with the family and whole palliative care team for end of life care to run really smoothly.”
National Palliative Care Week 2019 runs from 19-25 May. Organised by Palliative Care Australia (PCA), the national week is aimed to raise awareness and understanding about palliative care in the Australian community.
The 2019 theme ‘What Matters Most?’ addresses the need for Australians to plan ahead for their end of life care and discuss it with their loved ones and health professionals.
Ms Knowles is one of two Brisbane nurses who received scholarships to complete the Master of Nurse Practitioner program, specialising in palliative care.
An identified need to upskill nurses in palliative care led to establishment of the Palliative Care Nurse Practitioner (PCNP) Scholarship Program, a new Brisbane North PHN scholarship initiative.
Executive Manager for Aged and Community Care programs Michele Smith said a needs assessment had shown a high level of fragmentation in the delivery of palliative care services in the region.
“We recognise that the health system currently does not support people to die well at home, and there is also a lack of local data related to palliative care.”
Several scholarships for graduate certificate level qualifications in palliative care for nurses have also been offered by the PHN.
“The longer term goal of the scholarship program is to build a network of palliative care nurse practitioners across acute, community, aged and primary care with more effective and accessible services,” Ms Smith said.
Australian Institute of Health and Welfare statistics show the number of palliative care-related hospitalisations increased by 28% between 2011-12 and 2015-16, highlighting an increased need for palliative care services at a national level.
Ms Smith said there was increasing pressure for connected palliative care services across acute, community and primary care sectors.
One in every 90 employed nurses in 2016 were palliative care nurses or about 3,457 nurses nationally.
Australian College of Nurse Practitioners Queensland Chapter Chair Melanie Proper said palliative care was a huge area of need and the perfect place to position the NP model. “There is a lot of evidence to show it makes a huge impact on improving outcomes and increasing access.”
Brisbane North PHN scholarship recipients Ms Knowles of Mercy Community and Kathryn Hooper of St Vincent’s Private Hospital started their NP studies with Queensland University of Technology in February and are expected to graduate at the end of 2020.
“I am learning so much; it’s extending my scope of practice. It’s enjoyable and an eye-opener,” Ms Knowles said.
A former vascular RN, Ms Knowles started within the residential aged care facility at Mercy Community in 2010. She recently completed her Masters in Palliation and Dementia.
“I was interested [in the NP scholarship] as an avenue I could go down with my expertise as a specialist palliative care nurse in residential aged care and community.”
On completion of her studies, Ms Knowles will work in conjunction with another NP in palliative care at Mercy Community.
Ms Knowles is especially passionate about advocating for end of life care with people with dementia. She cares for people with dementia and chronic disease.
“You cannot put dementia into a little box. Dementia varies; and different dementias with other chronic disease is very complex.
“It’s so important to advocate for those with dementia. Sometimes a person is not really told about their prognosis of a chronic disease and a couple of years later on when the dementia has progressed and their cognitive side is hazy, they are then relying on family.
“You have a window of cognition with advance care planning for the person with dementia to decide what care is going to happen when they cannot make the decisions. A lot do not want to go back to hospital.”
Ms Knowles said she builds trust and gains rapport with patients and brings the family in.
“You have to be quite flexible and open. When you are having a conversation you need to go slowly so everyone can comprehend and grasp what you are saying, explain the trajectory of the chronic disease and what lies ahead,” Ms Knowles said.
“You need to plan for your future health and correlate a plan, that’s my approach. We will have a family conference and talk more about the ACP and what we are going to do in palliation.”
Palliative Care Australia resources available to health professionals and consumers and include the online Dying to Talk Discussion Starter and Dying to Talk Card Game to help work out what matters most to you.
PCA will be running social media competitions during Palliative Care Week on its Facebook and Twitter accounts. To join a Twitter conversation or competition use: #NPCW19 #dyingtotalk