Oncology nurses are in an ideal position to recommend early palliative care for patients. For this reason, in a recent Canadian study on brokering palliative care, researchers looked at the role of nurses as advocates for early palliation.1 Oncology nurses in Canada have different roles than their counterparts in the United States; staff nurses cannot refer patients for palliative care, but advanced practice nurses and nurse practitioners can. They identify patients who would benefit from early palliation and introduce or “broker” the concept to the patient and the doctor.

A stigma is still associated with palliative care as some clinicians continue to believe that the concept undermines a curative intervention. However, palliative care can be effectively introduced along with other treatments, and the combination of care improves patient symptoms and quality of life. Nurses, because of their routine interactions with patients, can participate in deciding who would benefit from palliation, acting as intermediaries between the oncologist and the patient in such situations.

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Researchers undertook a study to explore the unique psychosocial processes utilized by ambulatory care oncology nurses in introducing early palliative care to those patients the nurses felt would benefit from it. The study took place at Princess Margaret Cancer Centre, a comprehensive cancer hospital in Toronto, Canada.  Ambulatory care clinics, organized by disease site and primarily staffed by oncologists, advanced practice nurses, and registered nurses, provide outpatient oncology care. A number of the clinics are led by nurses and nurse practitioners, who in turn address patients’ symptoms and treatment concerns with the oncologist.

For the study, the Canadian group recruited 20 nurses: 10 nurse practitioners, 6 staff nurses, and 4 advanced practice nurses. Eighteen of the nurses were female; all ranged in age from 25 to 64. The primary goal of the research was “to conceptualize the psychosocial processes” involved in brokering palliative care by oncology nurses. The secondary goal was to determine how nurses draw on their relationships with patients when providing care. An oncology nurse who was a postdoctoral research fellow at the time conducted the one-on-one interviews, either in person or on the phone; each interview lasted approximately 1 hour.

This article originally appeared on Oncology Nurse Advisor