J Hosp Palliat Nurs. 2021 Feb 1;23(1):59-68. doi: 10.1097/NJH.0000000000000715.
Palliative care focuses on symptom management, discussion of treatment and care decisions, network organization, and support of the family. As part of the advance care planning (ACP) process, staff nurses in the acute care setting are often involved in all of the above areas. It is yet unclear what nurses' roles and responsibilities are and what skills are needed in the ACP process. The themes that staff nurses and advanced practice registered nurses (APRNs) discuss in relationship to ACP are manifold. This scoping review demonstrates that staff nurses' core role is advocating for the wishes and values of patients with any life-limiting disease. Staff nurses also serve as facilitators, educators, and advocates to help start ACP conversations and ease patients' transitions between settings based on well-discussed decisions. To be able to engage in ACP discussions, APRNs must have excellent communication skills. Continuous training to improve these skills is mandatory. In the future, clarifying the contribution of staff nurses and APRNs in the ACP process in relation to other members of the interprofessional team can lay the groundwork for improved interprofessional collaboration.
姑息治疗侧重于症状管理、治疗和护理决策的讨论、网络组织以及家庭支持。在预先医疗计划(ACP)的过程中,急性护理环境中的护士通常涉及所有上述领域。目前尚不清楚护士在 ACP 过程中的角色和责任,以及需要哪些技能。护士和高级实践注册护士(APRNs)在 ACP 方面讨论的主题是多方面的。这项范围综述表明,护士的核心角色是倡导所有患有绝症的患者的愿望和价值观。护士还担任促进者、教育者和倡导者,帮助开始 ACP 对话,并根据充分讨论的决策,缓解患者在不同环境之间的过渡。为了能够参与 ACP 讨论,APRNs 必须具备出色的沟通技巧。持续的培训以提高这些技能是强制性的。将来,澄清护士和 APRNs 在与跨专业团队其他成员相关的 ACP 过程中的贡献,可以为改善跨专业合作奠定基础。