Background/literature review A systematic review by Gardiner et al . (2012) identified as a priority the need for clarification and definition regarding roles and responsibilities of specialist providers. Misunderstandingthe roles and responsibilities of the PCNS has a negative impact on effective partnership working and detracts from providing high levels of expertise in an effective and efficient specialist palliative care service. Yet from scoping the literature it is apparent that defining, managingand evaluating the PCNS role is difficult (Skilbeck and Seymour, 2002; Corner et al . 2003).
Aim The overall aim of this study was to evaluate how Palliative Care Clinical Nurse Specialists describe and manage their role in the local context.
Method Aqualitative evaluation was undertaken utilising a phenomenological approach. Semi-structured interviews were undertaken with thirteen PCNS from acute and community setting. The verbatim transcripts were then analysed using an adapted version of Colaizzi's (1978) framework.
Findings Five common themes were identified that influenced how PCNS describe and manage their role; 1) other people's perceptions of the PCNS role, 2) the realities of being a PCNS, 3) the unique, changing and increasingly specialised nature of the PCNS role, 4) personal highlights and enabling factors and 5) personal disappointments and challenges.
Conclusion The PCNS experience of how they describe and manage their role is a complex and difficult process, with role conflicts and misunderstandings being a significant contributing factor. There is a challengeto defining complex/specialist input, which is open to interpretation and subjectivity. The study offers considerations for role definition, service specification and identifies the future challenges for the PCNS.
Application to hospice practice The study has generated common themes for discussion and provided unique understanding of the influences that impact upon how the PCNS describe and manage their role and the issues and challenges the PCNS face.
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