Co-ordination and delivering palliative and end of life care

The Northern Health and Social Care Trust (NHSCT), as part of its palliative care service improvement plan and in response to the Living Matters: Dying Matters regional strategy recommendations, is enhancing the skills of District Nursing Sisters to enable them to fulfil their role as palliative care keyworkers across community settings.

Co-ordinating care is vitally important to ensure the timely and appropriate provision of palliative and end of life care services. Commenting on this development Lorna Nevin, Service Lead for Palliative Care, Northern Trust said, “Our District Nursing Sisters are well placed to be palliative care key workers for patients and their families. They are already responsible for planning, co-ordinating and delivering the care needs for individuals who are living at home, throughout the various stages of an illness”.

“This process becomes even more important when a person is living with an advanced progressive illness and identified as having palliative or end of life care needs. The palliative care keyworker will be a source of support and information, promoting the right care at the right time for individuals, their families and carers.”

Feedback from patients and carers has highlighted the importance of having one key person providing regular contact with them especially towards the end of life. The palliative care keyworker will act as a conduit for communication to enable proactive coordination and care planning alongside the GP and other members of the community multidisciplinary team including specialists in palliative care. Should a hospital admission be required the palliative care key worker will appraise the ward team, when they become aware, of his/ her role and sustain links with the hospital team until discharge.”

Lorna Nevin says “Community nurses have always valued their role in providing palliative care. Twenty District Nursing Sisters are going through training to further enable them to lead on person centred palliative care, to help them identify what’s important to each individual during the last stage of life, to enable honest discussions and the chance to plan and to ensure that physical, emotional, spiritual and practical needs are meet through responsive and timely support. As palliative care key worker’s our District Nursing Sisters will be advocates for compassionate coordinated care.”

Pictured below are Lisa McDonnell, District Nursing Sister, Ballyclare Health Centre, Margaret Diamond, Community Professional & Practice Development Nurse and Bernadine Herron, District Nursing sister, Stewartstown Health Centre.

Page last updated:02 June 2015