Background As specialist palliative care services are evolving and reasons for admission to hospice are changing, the Ayrshire Hospice has developed an innovative model of practice within the In-Patient Unit (IPU) senior nursing team. One of the senior Hospice Specialist Palliative Care Nurses (SPCN) in this team identified in her personal development plan that experience in the acute setting working with the Hospital Specialist Palliative Care Team (HSPCT) would be of benefit. In collaboration with the local district general hospital a structured SPCN clinical secondment to the acute setting was developed and evaluated.
Objectives Develop understanding of the role of the HSPCT and of challenges specific to clinical practice in the acute setting. Develop and demonstrate skill and competency in multidimensional patient assessment. Manage own patient caseload. Develop skill in writing clinical letters. Increase awareness of key priorities of communication between the acute hospital and the community setting.
Method Two month secondment; clinical experience; working with the HSPCT; new patient and ward reviews; multidisciplinary team meetings; informal ward teaching; integrated liaison with hospice community team and multidimensional assessment of acute transfers to hospice. Electronic and letter communication, attendance at team development and clinical governance meetings.
Conclusion The acute hospital presents different challenges in day-to-day practice when compared to the specialist palliative care unit. This secondment facilitated and supported the development of autonomous practice and fulfilled the objectives. These are transferrable skills. On returning to the hospice the aim is to maintain and demonstrate this level of clinical assessment while encouraging staff to develop their own assessment skills further and continue to develop a workable SPCN patient caseload in the IPU. This will also support the opportunity to mentor hospital and community staff undertaking the ‘Nurses with a Specialist Interest in Palliative Care’ education programme during their hospice clinical attachment.
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