Most people have an understanding about the role of a doctor and a nurse. In the palliative care setting these health professionals have valuable skills and experience in caring for people with a life limiting illness.
General Practitioner (GP)
The GP is the main medical support for the patient and their family whilst they are at home or in an aged care facility. The GP can assist with symptom control and provide valuable psycho-social care to the patient and their family. The GP can also make referrals to specialists and to inpatient palliative care units.
Palliative care physicians
These are medical specialists who have advanced knowledge of palliative care. Their focus is often in controlling complex symptoms such as pain, nausea and shortness of breath. They would also be involved in managing any palliative care emergencies such as spinal cord compression. They often work alongside the GP and other members of the palliative care team.
Palliative care nurses
Palliative care nurses work in many different settings, such as hospitals, nursing homes, palliative care units and in the community. They can work both autonomously and as part of a team. Through their clinical knowledge and experience they aim to improve a person's quality of life through using quality assessment and evidence based symptom management. Part of their role includes the delivery of end of life care, often mentoring and educating other nurses in this area.
Nurses are well placed to provide practical and emotional support to the patient and their family and friends. Therefore palliative care nurses often have excellent communication skills and have completed some formal training in this area. The use of validated assessment tools also allow the palliative care nurse to identify when onward referral to a social worker, psychologist or pastoral care worker is needed.
A central part of a palliative care nurse's role is coordinating care, as often a number of health professionals are involved in delivering care to the patient and their family.
Nurse Practitioners
A Nurse Practitioner is a registered nurse educated and authorised to function autonomously and collaboratively in an advanced and extended clinical role in the speciality of palliative care. The Nurse Practitioner role includes assessment and management of patients using nursing knowledge and skills and may include but is not limited to the direct referral of patients to other health care professionals, prescribing medications and ordering diagnostic investigations.
The term allied health refers to health professionals other than doctors and nurses, and some examples are provided below.
Occupational therapy
Occupational therapy enables people with a life limiting illness to remain as physically independent as possible. The focus as with any palliative care intervention is to improve the patient's and their family's quality of life.
Often a person with a life limiting illness may have specific lifestyle goals they wish to achieve or maintain for as long as possible, and an occupational therapist may be able to assist. For example, if a patient who lived alone wanted to remain at home as long as they were able, aids such as raised toilet seats, shower chairs and an electric armchair could make a huge difference for them. Or for a fisherman who wanted to be able to sit down and look at the beach, a wheelchair and a portable oxygen machine could assist this person in achieving such a goal.
Occupational therapists are based both in acute hospital settings but also work in other settings including community palliative care teams, aged care organisations and the Department of Veteran Affairs.
Social worker