Missed opportunities: Nursing insights on end-of-life care for haematology patients

Authors

  • Pam McGrath BSocWk MA PhD,

    Corresponding author
    1. NH&MRC Senior Research Fellow, International Program for Psycho-Social Health Research, Central Queensland University, Brisbane, Queensland, Australia
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  • Hamish Holewa BSc(CompSci) BEd

    1. Research Officer, School of Nursing and Health, Central Queensland University, Brisbane, Queensland, Australia
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Pam McGrath, International Program for Psycho-Social Health Research, Central Queensland University, Brisbane Office, PO Box 1307, Kenmore, Brisbane, Qld 4069, Australia. Email: pam_mcgrath@bigpond.com

Abstract

There is now extensive consumer research to indicate that patients with haematological malignancies are not receiving appropriate or timely referrals to the palliative system. This paper begins to explore the issue from the professional perspective by presenting findings from haematology nurses on their experience with terminal care. The nursing insights have been gathered through open-ended interviews with a national sample of nurses with extensive experience in haematology in both public and private hospitals throughout Australia. The findings resonate with the previous consumer research in that all the acute care nurses affirmed that it is their belief, based on their professional experience, that patients from these diagnostic groups typically die in the acute ward dealing with escalating technology and invasive treatments. For some, the statements could be qualified by the satisfaction that they worked in a haematology unit, aware of the death-denying issues, trying to address the problem. Others, caught in a ‘refractory’ subculture (i.e. a subculture with a negative perception of palliative care), outlined the factors driving the lack of integration for their specific hospital. The focus of the discussion of findings is on the latter.

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