The commonality and synchronicity of mental health nurses and palliative care nurses: closer than you think? Part one

Telling their story: A qualitative descriptive study of the lived experience of expatriate palliative care nurses in the United Arab Emirates

PURPOSE

To explore the experiences of expatriate nurses caring for Muslim patients near end-of-life in a palliative care unit in the United Arab Emirates.

METHODS

A qualitative descriptive study, with data collected through semi structured individual interviews with nine expatriate nurses working in a palliative care unit in one hospital in the United Arab Emirates. Thematic analysis of the data transcripts used a structured inductive approach.

RESULTS

Analysis of the interview transcripts yielded three themes. First, language was a significant barrier in end-of-life care but was transcended when nurses practiced authentically, using presence, empathetic touch and spiritual care. Secondly, relationships between nurses, patients and families were strengthened over time, which was not always possible due to late presentation in the palliative care unit. Finally, nurses were continually in discussions with physicians, families and other nurses, co-creating the meaning of new information and experiences within the hospital policy context.

CONCLUSION

For expatriate nurses, palliative nursing in a Muslim middle eastern country is complex, requiring nurses to be creative in their communication to co-create meaning in an emotionally intensive environment. Like other palliative care settings, time can strengthen relationships with patients and their families, but local cultural norms often meant that patients came to palliative care late in their disease trajectory. Preparing expatriate nurses for work in specialist palliative care settings requires skill development in advanced communication and spiritual practices, as well as principles of palliative care and tenets of Muslim culture.

An examination of the scope and purpose of education in mental health nursing

This study examined the education of mental health nurses by surveying all qualified mental health nurses working within one National Health Service region in Scotland. Using an adaptation of a previously used instrument, 488 questionnaires were distributed producing a response rate of 194 (39.75%). The study's themes - initial preparation, professional development and future practice - reveal findings of interest, particularly the axis of RMN (pre-1992 education) and RMN (Project 2000 education). In terms of initial preparation, clear differences between groups were found. Pre-1992 RMNs' report on educational experience majoring on practical skills contrasts sharply with Project 2000 respondents who, in spite of a course philosophy of reflective practice, emphasised an apparent lack of practical skills for practice. For professional development, both groups valued flexible approaches via journal reading, teaching, networking and participating in clinical supervision. In terms of educational provision, short course provision with an emphasis on short, flexible course provision (e.g., in-service study days), practice education and closer (and flexible) links between higher education and the practice area were highlighted as the most important ways to prepare for future practice.

Theraputic relationships in specialist palliative care nursing practice

There has been limited research into the scope or standards of specialist palliative care nursing practice in an Australian context. This study sought to develop a competency framework that described the core domains of specialist palliative care nursing. This article explores one key domain of specialist palliative care nursing practice - therapeutic relationships - that was identified as underpinning other domains of practice. A mixed method was used, involving a literature review, a survey including practice exemplars and an interview of specialist palliative care nurses. Seventy-four registered nurses working in designated specialist palliative care nursing roles from each Australian state and mainland territory were involved. The nurses represented metropolitan, regional, rural and remote communities, various inpatient facilities and community practice settings. Five core domains of specialist palliative care nursing practice were identified: complex supportive care, collaborative practice, leadership, improving practice and therapeutic relationships. Therapeutic relationships were identified as the central domain of specialist palliative care nursing practice to which all other domains were inextricably linked.

Quality of life for long-stay patients of psychiatric hospitals: a literature study

The aim of this literature review is to provide an answer to the following questions: (1) What is known about the quality of life and quality of care for long-stay psychiatric patients? (2) What does literature say about possible contributions that health-care professionals may make to the quality of life for this target group? We conducted an open literature search across national and international databases, and added relevant literature by using cross-references. The quality of life and quality of care for long-stay psychiatric patients has been the subject of research on a limited scale only. Publications in this field provide a picture of patients with wishes and requirements that are generally basic and modest in nature. They also show that patients greatly value good relations with their care providers. This literature review shows that little is known about the quality of life of long-stay psychiatric patients and this review also shows that the relational aspects of care provide an eminent opportunity for care providers to contribute to the quality of life of their patients. Long-stay patients need care providers who are capable of developing and maintaining a caring relationship of the highest quality that will endure for many years. In their daily work, nurses have good opportunities to develop and maintain meaningful and reciprocal relationships with severely ill people, but this is a task that makes great demands on nurses in terms of both knowledge and interhuman skills. These skills should be given special attention both in nurse education and by supervisors.

Variant Creutzfeldt-Jakob disease: need for mental health and palliative care team collaboration

People with a dementia syndrome and a superimposed terminal illness are increasingly being referred to palliative care services. Creutzfeldt-Jakob disease (CJD) is a dementia syndrome in the early stages of which people experience a variety of psychological symptoms that may lead to them being admitted to psychiatric services. People with CJD have died in psychiatric units. There is clearly a need for collaboration between mental health and palliative care services in providing care for people with CJD and other dementia syndromes. An inductive qualitative study of one case of variant CJD (vCJD) was carried out to explore issues that were raised in providing care for a young person with the disease who had died in a hospice unit. The study, which was a pilot for a larger study, highlights some of the complexities of providing care for people with an end-stage dementia and identifies the need for the development of education initiatives to increase knowledge and understanding of the end-of-life needs of people with CJD and other dementia syndromes, and their families.