‘When a patient chooses to die at home, that's what they want… comfort, home’: Brilliance in community‐based palliative care nursing
Abstract Introduction To redress the scholarly preoccupation with gaps, issues, and problems in palliative care, this article extends previous findings on what constitutes brilliant palliative care to ask what brilliant nursing practices are supported and promoted. Methods This study involved the me...
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Format: | Article |
Language: | English |
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Wiley
2023-08-01
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Series: | Health Expectations |
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Online Access: | https://doi.org/10.1111/hex.13780 |
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author | Ann Dadich Dr Michael Hodgins Kerrie Womsley Dr Aileen Collier |
author_facet | Ann Dadich Dr Michael Hodgins Kerrie Womsley Dr Aileen Collier |
author_sort | Ann Dadich |
collection | DOAJ |
description | Abstract Introduction To redress the scholarly preoccupation with gaps, issues, and problems in palliative care, this article extends previous findings on what constitutes brilliant palliative care to ask what brilliant nursing practices are supported and promoted. Methods This study involved the methodology of POSH‐VRE, which combines positive organisational scholarship in healthcare (POSH) with video‐reflexive ethnography (VRE). From August 2015 to May 2017, inclusive, nurses affiliated with a community health service who delivered palliative care, contributed to this study as co‐researchers (n = 4) or participants (n = 20). Patients who received palliative care (n = 30) and carers (n = 16) contributed as secondary participants, as they were part of observed instances of palliative care. With a particular focus on the practices and experiences that exceeded expectations and brought joy and delight, the study involved capturing video‐recordings of community‐based palliative care in situ; reflexively analysing the recordings with the nurses; as well as ethnography to witness, experience, and understand practices and experiences. Data were analysed, teleologically, to clarify what brilliant practices were supported and promoted. Results Brilliant community‐based palliative care nursing largely involved maintaining normality in patients’ and carers’ lives. The nurses demonstrated this by masking the clinical aspects of their role, normalising these aspects, and appreciating alternative ‘normals’. Conclusion Redressing the scholarly preoccupation with gaps, issues, and problems in palliative care, this article demonstrates how what is ordinary is extraordinary. Specifically, given the intrusiveness and abnormalising effects of technical clinical interventions, brilliant community‐based palliative care can be realised when nurses enact practices that serve to promote a patient or carer to normality. Patient or Public Contribution Patients and carers contributed to this study as participants, while nurses contributed to this study as co‐researchers in the conduct of the study, the analysis and interpretation of the data, and the preparation of the article. |
first_indexed | 2024-03-11T10:16:11Z |
format | Article |
id | doaj.art-dd2880b715194ed29bda176fc39c8c84 |
institution | Directory Open Access Journal |
issn | 1369-6513 1369-7625 |
language | English |
last_indexed | 2024-03-11T10:16:11Z |
publishDate | 2023-08-01 |
publisher | Wiley |
record_format | Article |
series | Health Expectations |
spelling | doaj.art-dd2880b715194ed29bda176fc39c8c842023-11-16T08:25:36ZengWileyHealth Expectations1369-65131369-76252023-08-012641716172510.1111/hex.13780‘When a patient chooses to die at home, that's what they want… comfort, home’: Brilliance in community‐based palliative care nursingAnn Dadich0Dr Michael Hodgins1Kerrie Womsley2Dr Aileen Collier3School of Business Western Sydney University Parramatta New South Wales AustraliaSchool of Clinical Medicine University of New South Wales Sydney New South Wales AustraliaPalliative Care Service Illawarra Shoalhaven Local Health District Wollongong New South Wales AustraliaFaculty of Medical and Health Sciences University of Auckland Auckland New ZealandAbstract Introduction To redress the scholarly preoccupation with gaps, issues, and problems in palliative care, this article extends previous findings on what constitutes brilliant palliative care to ask what brilliant nursing practices are supported and promoted. Methods This study involved the methodology of POSH‐VRE, which combines positive organisational scholarship in healthcare (POSH) with video‐reflexive ethnography (VRE). From August 2015 to May 2017, inclusive, nurses affiliated with a community health service who delivered palliative care, contributed to this study as co‐researchers (n = 4) or participants (n = 20). Patients who received palliative care (n = 30) and carers (n = 16) contributed as secondary participants, as they were part of observed instances of palliative care. With a particular focus on the practices and experiences that exceeded expectations and brought joy and delight, the study involved capturing video‐recordings of community‐based palliative care in situ; reflexively analysing the recordings with the nurses; as well as ethnography to witness, experience, and understand practices and experiences. Data were analysed, teleologically, to clarify what brilliant practices were supported and promoted. Results Brilliant community‐based palliative care nursing largely involved maintaining normality in patients’ and carers’ lives. The nurses demonstrated this by masking the clinical aspects of their role, normalising these aspects, and appreciating alternative ‘normals’. Conclusion Redressing the scholarly preoccupation with gaps, issues, and problems in palliative care, this article demonstrates how what is ordinary is extraordinary. Specifically, given the intrusiveness and abnormalising effects of technical clinical interventions, brilliant community‐based palliative care can be realised when nurses enact practices that serve to promote a patient or carer to normality. Patient or Public Contribution Patients and carers contributed to this study as participants, while nurses contributed to this study as co‐researchers in the conduct of the study, the analysis and interpretation of the data, and the preparation of the article.https://doi.org/10.1111/hex.13780brilliant carecommunity healthknowledge translationpalliative carepositive organisational scholarshipteleological analysis |
spellingShingle | Ann Dadich Dr Michael Hodgins Kerrie Womsley Dr Aileen Collier ‘When a patient chooses to die at home, that's what they want… comfort, home’: Brilliance in community‐based palliative care nursing Health Expectations brilliant care community health knowledge translation palliative care positive organisational scholarship teleological analysis |
title | ‘When a patient chooses to die at home, that's what they want… comfort, home’: Brilliance in community‐based palliative care nursing |
title_full | ‘When a patient chooses to die at home, that's what they want… comfort, home’: Brilliance in community‐based palliative care nursing |
title_fullStr | ‘When a patient chooses to die at home, that's what they want… comfort, home’: Brilliance in community‐based palliative care nursing |
title_full_unstemmed | ‘When a patient chooses to die at home, that's what they want… comfort, home’: Brilliance in community‐based palliative care nursing |
title_short | ‘When a patient chooses to die at home, that's what they want… comfort, home’: Brilliance in community‐based palliative care nursing |
title_sort | when a patient chooses to die at home that s what they want comfort home brilliance in community based palliative care nursing |
topic | brilliant care community health knowledge translation palliative care positive organisational scholarship teleological analysis |
url | https://doi.org/10.1111/hex.13780 |
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