Integrating palliative care into daily practice: a nursing perspective

Education of health care providers has historically been based on the traditional model of curative care. In this model, the curative care focus suddenly ends, substituted by a palliative approach to care, too often only in the last hours of life. Patient goals and wishes may never be clearly established, leaving family and care providers to guess at what the patient's wishes were. If we are to provide quality palliative care, we must equate it with health care providers establishing, acknowledging, and honoring patient and family goals. A major facilitator in accomplishing palliative care goals can arise from the nursing assessment. This article reviews the elements of a comprehensive nursing palliative care assessment (PCA). Although this article focuses on nurses, it has application for all health care professionals. Completion of the PCA provides an opportunity for reflection and evaluation of personal practices that support integrating palliative care into the care of all patients diagnosed with a life-threatening illness, beginning at the time of diagnosis and accelerating in intensity as the disease progresses.