The role and significance of nurses in managing transitions to palliative care: a qualitative study

Kirby, Emma, Broom, Alex and Good, Phillip (2014) The role and significance of nurses in managing transitions to palliative care: a qualitative study. BMJ Open, 4 9: 1-8. doi:10.1136/bmjopen-2014-006026

Author Kirby, Emma
Broom, Alex
Good, Phillip
Title The role and significance of nurses in managing transitions to palliative care: a qualitative study
Journal name BMJ Open   Check publisher's open access policy
ISSN 2044-6055
Publication date 2014-09-30
Year available 2014
Sub-type Article (original research)
DOI 10.1136/bmjopen-2014-006026
Open Access Status DOI
Volume 4
Issue 9
Start page 1
End page 8
Total pages 8
Place of publication London, United Kingdom
Publisher B M J Publishing Group
Collection year 2015
Language eng
Formatted abstract

Nurses are generally present, and often influential, in supporting patient and family acceptance of medical futility and in assisting doctors in negotiating referral to palliative care. Yet the specificities of the nursing role and how nurses may contribute to timely and effective referrals is not well understood. This study aimed to systematically explore hospital-based nurses’ accounts of the transition to palliative care, and the potential role of nurses in facilitating more effective palliative care transitions.


Qualitative study using semistructured interviews.


Two health services with public as well as private clinical environments in a major metropolitan area of Australia.


Hospital-based nurses (n=20) who regularly work with patients at the point of referral and in managing transitions to palliative care.


Four significant themes emerged from thematic analysis. These include: (1) professional dynamics and the roles played by nurses in initiating the transition to palliative care; (2) the value of nurses’ informal interactions in timely and effective transitions; (3) the emerging challenge of managing task-oriented nursing versus intense emotional nursing work at the point of medical futility and (4) the emotional burden experienced by nurses within this clinical context. Nurses self-reported occupying critical albeit complex roles in the management of medical futility and the transition to palliative care. They reported experiencing significant emotional burden in balancing interpersonal and interprofessional relationships during this time.


The results suggest that nurses may be utilised in a more formalised and systematic fashion in the context of managing medical futility and the need to topicalise the transition, with the focus shifted away from medical referrals towards more team-based and patient-centred timely transitions. Further research focused on the experiences of doctors, allied health professionals, patients and families is required to provide a broader interdisciplinary understanding of futility and contributions to the negotiation of palliative care.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Social Science Publications
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Created: Tue, 21 Oct 2014, 04:14:57 EST by System User on behalf of School of Social Science