Introduction 

Care coordination of palliative care clients in the community setting is complex. Clinicians must have a broad range of skills in assessment, recognising deteriorating clients, complex symptom management, leading difficult conversations with clients and carers. Nursing teams have a broad skill mix from experienced community nurses, to beginning career nurses. 

Aims 

The aim of the project was to test if structured and standardised approach to orientating new staff to palliative care in the community enhanced their skills and confidence in providing care.

Methods

A Palliative Care Skills self-assessment tool was developed incorporating core skills required to provide palliative care nursing in a community setting. Skills were assessed using ‘Benners Stages of Clinical Competence’ prior to commencing the Palliative Care Pathway (the pathway). 

An orientation guide with a set of skills  across clinical and non-clinical domains was developed by the Clinical Nurse Consultant (CNC). The Registered Nurses (RN) were provided with a booklet outlining skills to achieve with support of the palliative care nursing .The CNC met individually with each staff member to discuss their initial self-assessment and provided them with a list or resources specific to palliative care. A follow up self-assessment was performed at the end of 6 months on the pathway. 

Participating RNs were interviewed after 6 months. The interviews were informal and exploring the process of following the structured orientation pathway.

Conclusion

The pilot project made a difference to the nursing staff as they felt supported by having a structured process to develop their skills.  The specialist palliative care nursing team was able to assess the development of nurses skills using a standardised process with a structure directing their learning. The Pathway is now embedded in the standard orientation of new Registered Nursing staff in the community nursing team.