Relationship of Clinical Nursing Competence to Nursing Occupational Experience in Hospice/Palliative Care Nurses in Japan

Aim: The purpose of this research is to examine the relationship between the clinical nursing competence and nursing occupational experience in hospice/palliative care nurses (HPN) in Japan. Methods: A mail survey using an anonymous self-administered questionnaire was conducted on clinical nursing competence regarding communication, care and prediction of worsening of symptoms with the authors’ previous research as a framework. The subjects were nurses working in hospice/palliative care units in Japan, and the period of survey was January to February, 2014. Results: In this study, the relationship between the clinical nursing competence and nursing occupational experience of HPNs in hospice/palliative care which was clarified in the authors’ previous research was examined. The results showed that the amount of clinical nursing experience as a nurse was related to clinical nursing competence in the care of end-of-life patients and worsening of symptoms. The abundance of specialized nursing experience was also related to clinical nursing competence in communication in addition to care and prediction of worsening of symptoms. Training experience was also shown to be effective for hospice/palliative care. Conclusion: From these results, clinical nursing competence of HPNs in care of end-of-life patients and prediction of worsening of symptoms are possibly learned through the accumulation of clinical nursing experience as a nurse. However, HPN’s clinical nursing competence in communication was suggested to be developed through nursing practice in hospice/palliative care.

Characteristics of Nursing Care for Terminally Ill Patients in Hospice/Palliative Care Unit

The purpose of this study was to clarify the characteristics of nursing care for patient with terminally ill in the hospice/palliative care units. Semi-structured interviews on “communication, care, spiritual pain care and prediction of worsening of symptoms” were conducted, incorporating items indicated as important principles of palliative care by Lugton et al. Sixteen nurses at five hospice/ palliative care facilities in urban areas of Japan were surveyed in 2013, and results were analyzed qualitatively. Following characteristics by hospice/palliative care nurses (HPN) were categorized as [HPN sharing meaningful time with the patient] and [HPN’s continual attempts to understand the world in which the patient lives] in the communication;as [HPN providing comfortable care so that patients can value their last moments] and [HPN’s efforts to attend to patients so they can die as they hope to] in the care;and as [HPN’s observation in a range that does not interfere with the patient’s comfort] and [HPN senses that something is different from before] in the prediction of worsening of symptoms. Common characteristic was 【HPN’s support for patients approaching a natural death】. In this study, spiritual pain care was included in the communication and care, and could not be extracted alone. It was suggested that an HPN provides communication, care and prediction of worsening of symptoms with excellent judgment and technological competency, while placing importance on offering support for the patient’s natural death.