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Heart failure nurses’ experiences of specialist palliative care
  1. Anita Sargeant, Lecturer in Nursing,
  2. Sheila Payne, Help the Hospices Chair,
  3. Jane Seymour, Sue Ryder Care Professor and
  4. Christine Ingleton, Reader
  1. Anita Sargeant is Lecturer in Nursing, School of Health Studies, University of Bradford (formerly Research Fellow, Institute for Health Research, Lancaster University), Sheila Payne is Help the Hospices Chair in Hospice Studies, The Institute for Health Research, Lancaster University, Jane Seymour is Sue Ryder Care Professor of Palliative and End of Life Studies, School of Nursing, University of Nottingham, Christine Ingleton is Reader in Palliative and End-of-Life Studies, Centre for Health and Social Care Studies, University of Sheffield. Email: a.r.sargeant{at}bradford.ac.uk

Abstract

Background: A key innovation in the care of patients suffering heart failure, who have palliative and end-of-life care needs, has been the introduction of specialist heart failure nurses. Aim: The aim of this article is to report and contrast the views and experiences of specialist heart failure nurses caring for patients with heart failure who are approaching the end of life in three settings in the UK. Sample: A purposive sample of heart failure nurses (n=15) was recruited as part of a wider independent evaluation of the Marie Curie ‘Delivering Choice Programme’. Method: Three focus groups elicited information about the nurses’ roles, referral processes and working relationships with local hospice and palliative care services. Transcripts from the data collected in the focus groups were analysed using a modified grounded theory approach. Results: The uncertain trajectory of heart failure and the possibility of sudden death challenge models of palliative care developed in the context of cancer. Heart failure nurses from all three settings perceive that regular contact with patients for symptom management and supportive care prevents unwanted hospital admissions and provides carer support. The nurses welcome specialist palliative care advice and education but express concerns about overburdening local hospice services. Nurses report that, in their experience, many patients do not achieve their end-of-life care preferences because a wider network of support is lacking. Conflicts of interest: none

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