The nurse as coach in care of the dying

Nurses' inability to articulate many aspects of their work leads to its invisibility, a problem compounded in home-based palliative care where the nurse's work is rarely seen by others. A staff development exercise was undertaken which aimed to assist specialist palliative care nurses to articulate their relationships with patients to members of the inter-disciplinary team. The process was specifically aimed at understanding patients' and families' refusals to receive psycho-social care from other team members. It explores, through four narrative vignettes, the tension between nursing and non-nursing roles when patients refuse non-nurse care. At the centre of this tension are the issues inherent in nursing roles which frequently sit at the boundaries of other health practitioners.