Cumming M, Boreland F, Perkins D
Far West Local Health District, NSW, PO Box 457, Broken Hill, NSW 2880, Australia.
Aust J Prim Health. 2012;18(4):274-83. doi: 10.1071/PY11150.
Community primary health care nurses in rural and remote settings are required to provide palliative care as part of their generalist role. They have limited access to specialist medical and nursing support and sometimes there are no resident GPs. A study consisting of a mailed survey and follow-up interviews was conducted to explore the experiences of these nurses and to determine how personally and professionally equipped they felt for palliative care service provision. Most participants were registered nurses experienced in nursing and in rural and remote settings, who juggled multiple generalist work roles. They had only occasional palliative care patients, and more than half had provided palliative care for a friend or family member. Some nurses found palliative care rewarding, others preferred not to have to do it. However, even those who did not enjoy working with palliative care patients often went beyond the 'call of duty' to support a home death if that was what the patient wanted. Three-quarters had attended palliative care education in the last 2 years but 88% wanted more education. Barriers to education included competing work roles, work load, geographical isolation and lack of backfill. Support from managers and peers was considered important, as was accessing timely and relevant clinical support.
农村和偏远地区的社区初级保健护士需要在其全科角色范围内提供姑息治疗。他们获得专科医疗和护理支持的机会有限,有时甚至没有常驻的全科医生。一项包括邮寄调查和后续访谈的研究开展,以探索这些护士的经历,并确定他们在个人和专业方面对提供姑息治疗服务的准备程度。大多数参与者是在护理以及农村和偏远地区工作方面有经验的注册护士,他们身兼多种全科工作角色。他们偶尔才有姑息治疗患者,超过半数曾为朋友或家庭成员提供过姑息治疗。一些护士觉得姑息治疗很有意义,另一些则不愿从事这项工作。然而,即使是那些不喜欢护理姑息治疗患者的护士,如果这是患者的意愿,也常常会超出“职责要求”去支持患者在家中离世。四分之三的人在过去两年参加过姑息治疗培训,但88%的人希望获得更多培训。培训的障碍包括相互冲突的工作角色、工作量、地理位置偏远以及缺乏人员替补。管理者和同事的支持被认为很重要,及时获得相关临床支持也同样重要。