Mediating conflict and control: practice challenges for nurses working in palliative care

Area of Science:

• Palliative Care Nursing
• Professional Development
• Healthcare Systems

Background:

• Palliative care nursing demands advanced psychosocial skills.
• Professional development programs can enhance nursing practice.
• Understanding challenges in palliative care is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate a work-based professional development program for palliative care nurses.
• To improve nurses' skills in psychosocial care.
• To explore challenges faced by nurses in palliative care settings.

Main Methods:

• A work-based professional development program was implemented.
• Registered nurses participated in critical reflection on shared practice incidents.
• Fifteen challenging incidents in palliative nursing were analyzed.

Main Results:

• Themes of conflict and control emerged from the practice incidents.
• Nurses acted as mediators in complex care situations.
• Patient advocacy and professional autonomy were challenged by hierarchical and bureaucratic structures.

Conclusions:

• Shared experience and collective action in reflection are most effective for organizational learning.
• Critical reflection on practice incidents can illuminate systemic challenges in healthcare.
• Professional development should address the complexities of psychosocial care and systemic barriers.