Although the nurse practitioner (NP) roles are yet to be fully understood in many care settings around the world due to lack of clarity and a better definition, it is largely documented in the nursing scholarship that such roles can be of immense importance in improving healthcare delivery and increasing efficiency of the workforce (Kaasalainen et al., 2013). The present paper summarizes two research articles and one expert opinion article to shed light on the NP’s role in providing palliative health care services.
In their qualitative study using a sample of 143 participants, Kaasalainen et al (2013) attempted to interrogate the role of the NP in the provision of specialized care for people with serious medical conditions and who were residents of long-term care homes. The study findings are interesting and insightful, and reveal that (1) the nursing practitioner role in this type of care assumes a multi-level approach, including taking care of the elderly and their relatives on a daily basis, liaising with other healthcare providers in seeking solutions, and working within the care system not only to enhance access to care but also to facilitate the uneventful transition, (2) the NP has the capacity to promote optimal palliative care by engaging in various clinical, consultative and decision making activities, and (3) the NP’s main engagements in palliative care include the management of patient symptoms, education and counseling, coordination and provision of care, as well as consultation with other professionals in the care continuum regarding the patient’s condition or treatment arrangements (Kaasalainen et al., 2013).
In their quantitative study utilizing a sample of 49 patients sampled from a primary palliative care clinic, Owens, Eby, Burson, Green, McGoodwin, and Isaac (2012) set out to investigate if individuals with a serious medical condition would demonstrate enhanced symptom management and minimal emergency department (ED) utilization over the course of their illness if they were exposed to primary care and palliative care originating from a qualified NP rather than a consistent provider. In the context of this paper, the findings of their study demonstrate that (1) NPs provision of health care to patients with terminal illnesses reduces ED utilization at the end of life, (2) attendance of patients to NP clinics can improve symptom management, and (3) the experience and education of these professionals are superlatively nested to manage many of the care needs for individuals with terminal illnesses (Owens et al., 2012).
In an expert opinion article appearing on The Wall Street Journal about whether nurse practitioners should be allowed to treat patients in the absence of the oversight provided by a qualified physician, one senior expert within the NP profession is of the opinion that NPs not only have the capacity to provide professional care but are also licensed to treat patients with serious medical conditions, hence should be allowed to practice autonomously. The expert notes that NPs spend more time with patients than physicians do and hence are better placed to understand their healthcare needs, not mentioning that this group of professionals is more versed with availing rigorous health education to patients, counseling and care coordination. In contrast, another expert aligned with the physician’s profession is of the opinion that NPs do not have the capacity to replace primary-care doctors or work outside the scope of the collaboration provided for by the physicians, and that the work of an NP begins only when a physician makes a diagnosis (“Should Nurse Practitioners,” 2013).
Overall, from the summary of the three articles, it is clear that an underlying role for the NP should be to provide palliative health care services to patients, as the evidence demonstrates they are well placed to manage palliative care environments and to assist remodel care delivery to meet the healthcare needs of patients. The argument by Reid Blackwelder that NPS lack adequate education and experience is a non-starter as the two research articles have demonstrated the immense benefits NPs can bring in terms of improving outcomes for patients as well as for other nurses.
Kaasalainen, S., Ploeg, J., McAiney, C., Martin, L.S., Donald, F., Martin-Misenes, R…Sangster-Gormley, E. (2013). Role of the nurse practitioner in providing palliative care in long-term care homes. International Journal of palliative Nursing, 19(10), 477-485.
Owens, D., Eby, K., Burson, S., Green, M., McGoodwin, W., & Isaac, M. (2012). The primary palliative care clinic pilot project demonstrates the benefits of a nurse practitioner-directed clinic providing primary and palliative care. Journal of the American Academy of Nurse Practitioners, 24(1), 52-58.
Should nurse practitioners be able to treat patients without physician oversight? (2013). The Wall Street Journal. Web.