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Psychological challenges for nurses working in palliative care and recommendations for self-care

22 April 2021
Volume 30 · Issue 8


Working in palliative care services has an impact on the personal and professional lives of healthcare staff. The complex practicalities of the role and additional factors such as moral distress, burnout, compassion fatigue and death anxiety all impact on the overall quality of services and patient care. This article aims to highlight what is known of the practical and emotional challenges for palliative nursing care and offers recommendations to services to support staff at an organisational as well as individual level, to help create a more supportive workplace for staff and patients alike. It follows previous research on working in palliative and end-of-life care.

The past decade has highlighted the need to humanise health care (Health Foundation, 2014; Health Education England, 2019; West, 2019). Launched in 2012, the Compassion in Practice framework was developed for nurses across all specialties in England and identified the six core qualities—care, compassion, competence, communication, courage and commitment—to underpin the values of health care for the benefit of staff and patients alike (Cummings and Bennett, 2012). The framework was significant given the findings of the subsequent Francis report (2013), which highlighted the reciprocal relationship between poor staff care and poor patient care (related to a lack of action on staff concerns). The report concluded with a recommendation for a change of culture within healthcare services on governance, organisational and profession-specific levels of healthcare services.

Concurrently, directives specific to palliative nursing encouraged staff to address bio-psycho-social aspects of palliative healthcare (Marie Curie, 2017; Macmillan Cancer Support, 2017; NHS England, 2019).

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