How do we secure the future of the art of nursing?

Supporting health care professionals as they provide essential holistic care at end of life

Maaike Vandeweghe – Senior Educationalist

Earlier this month, I joined a Palliative Discovery Roundtable and I was struck by a big and, if I’m honest, slightly worrying question.

These half-day sessions are designed to facilitate in-depth, peer-to-peer discussions about palliative conundrums. They’re a chance for members of the programme, mostly Clinical Nurse Specialists working in palliative care, to consider complex end of life topics that have a limited evidence base.

The topic up for discussion on this occasion certainly met the brief. The assembled nurses and facilitators were faced with Struggling with a sense of safety, encountering fear and terror at the end of life.

As I sat there and listened to one CNS after another recount real, raw stories of pain, fear and suffering, it hit me: how do we secure the future of the art of nursing?

Being with people as they face this, the toughest time of their life, is absolutely part of what nurses should be doing. My fear is that their working environment has become so dominated by data rather than addressing patients’ suffering. If caring for people at the end of life becomes solely about Key Performance Indicators then something’s gone badly wrong.

The real art of nursing is about being present, about sitting with people, maybe holding their hand as well as the space. That is what palliative care nursing is about and what makes the people who do it so amazing.

The necessary restrictions of COVID-19 have made things a thousand times more difficult. Nurses have had to communicate either from behind a mask or via a screen. How can you practice the art of nursing if it’s not even possible to communicate a smile to your patient?

My fear is that what started as necessary precautions are becoming permanent measures and that the focus is more on tasks than on patient needs and that the art of nursing could be lost.

How timely then that, here at St Christopher’s CARE, we have been reassessing our education and learning offer. And the starting point is, how do we support health care professionals to provide that holistic care that is essential in palliative care? We need a contemporary, cutting edge approach that addresses issues like suffering so that nurses who are relentlessly exposed to terror have somewhere to turn, rather than just a short team de-brief.

The Lantern Model, the first new model of palliative care nursing for a generation, that we launched last year, and Palliative Discovery will help to form the templates for future learning experiences and, while we lay the foundations for the new cutting-edge programme, please do seek out these two programmes if you haven’t yet had the chance.

Together we will ensure that the art of nursing not only survives but thrives.