Introduction In the UK, clinical nurse specialists working across a variety of disciplines are key providers of generalist palliative care. However, the CNS contribution to palliative care is often unacknowledged and little is known about the palliative care skills and expertise of the CNS workforce. The aim of this study is to explore the role of CNS’s in supporting patients with palliative care needs, using a case study of mesothelioma clinical nurse specialists (MCNSs).
Methods The study used a mixed methods design involving: (i) secondary analysis of existing research data from the National Mesothelioma Outcomes, Research and Experience (MORE) Survey in 2019, completed by 510 patients; (ii) an on-line survey of 23 MCNSs exploring delivery of palliative care and; (iii) focus groups and individual interviews with 16 MCNSs to explore their role in palliative care provision.
Findings Five key findings were generated from the research: (1) MCNS’s are highly skilled at providing palliative care, the majority have received training or education in palliative care; (2) there is an important distinction between ‘specialist’ palliative care and ‘generalist’ palliative care in mesothelioma; (3) all MCNS’s provide generalist palliative care and some also provide specialist palliative care, potentially reducing/delaying the need for additional specialist palliative care provision (4) good partnership working between MCNSs and specialist palliative care is crucial to ensure patients receive seamless care; (5) a co-ordinated approach to a patients care is crucial.
Conclusion MCNS’s are skilled providers of palliative care, there is some evidence that the MCNS role may mitigate the need for specialist palliative care in mesothelioma. Further research is required to explore whether these findings can be replicated in other health conditions requiring palliative care. However, this study illustrates the significant potential for CNSs to support provision of both specialist and generalist palliative care in life limiting conditions.
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