The purpose of this assignment is to compare and contrast the current literature related to advanced nursing practice. And to relate this literature to my practice and the role of the palliative care nurse across clinical settings.
In my current role as a pain nurse specialist, I am involved in the care and management of patients with intrathecal (IT) catheters mainly for patients with intractable cancer pain. Patients who have been tried and failed on escalating doses of various opiates, and continue to have unsatisfactory pain management with intolerable side effects are often referred to our service for consideration for an intrathecal catheter. Intrathecal catheters have been used for many years now in effort to target the specific pain pathways within the spinal cord, as the medication is delivered directly into the Central nervous system, only small doses are required, and therefore patients experience less side effects, with improved pain control (Myers, J.
Chan, V., Jarvis, V., Walker-Dilks, C., 2010). The majority of these patients are approaching the end stages of their disease process, therefore we work quite closely with the hospital Palliative care service when the patient in an inpatient. However post discharge we visit the patients weekly in their own homes, this often involves working at an advanced nursing level, working autonomously, assessing the patient and titrating medication via their IT pump, with some direction from the doctor at Auckland hospital. However this role also involves providing the patient and their family with an element of palliative care also, they often require additional emotional support at this stage.
In 2002 the World health organization (WHO) defined palliative care as
" An approach that improves the quality of life of patients and their families facing he problems associated with life threatening illness, through the prevention and relief...