PALLIATIVE CARE

Role of district and community

nurses in bereavement care:
a qualitative study
Anna Johnson
Adult Nurse Lecturer, Department of Clinical Health Care, Faculty of Health and Life Sciences, Oxford Brookes University

annawake@brookes.ac.uk

A ccording to the Guidance for Professionals on Developing

Bereavement Services developed by the Bereavement
Services Association and National End of Life Care
Programme (2011:3):
The care of people in the last few days of life and
the availability of care and support for people that
are bereaved is an essential component of good end
of life care.
As district nurses are one of the main providers of good
end-of-life care, we can extrapolate from the above statement
that they are also involved in providing some form of bereave-
ment care. However, within the authors area of practice, the
importance is not always recognised. Lack of awareness could
be the contributing factor, as this research aims to determine.
ABSTRACT
Background: The district nurse is one of the main providers of palliative
care, which includes bereavement care. However, previous evidence shows
a lack of education and training, as well as time management, as important
factors in the delivery of bereavement care. Aim: This qualitative study
aimed to explore the provision of bereavement care from a district nurses
perspective. Method: Data were collected from fiveparticipants using semi-
structured interviews, and thematically analysed to produce the findings.
The interviews were conducted within the authors and participants working
environments to maintain a professional stance between both parties.
Findings: The results suggest an awareness of bereavement care, but
a lack of training and education into the theoretical aspects of the care.
Knowing the types and stages of bereavement would be beneficial, both
in the delivery and the identification of the most effective time to refer on.
Conclusion: Bereavement care was understood to be part of the district
nurse role, but the findings suggest that some nurses get too involved and
no end date could be standardised, as each case is dependent on need.
More experience of bereavement care and exposure increased awareness
The intention of the district nurse in providing bereavement
care is to assist the bereaved in their recovery and to recognise
any signs of complications/risks of bereavement (Redshaw
et al, 2013). The familiarity of the district nurse and build-
ing upon therapeutic relationships and personalised care helps
toward a better bereavement outcome for carers (Walshe and
Luker, 2010; Chang et al, 2012). Since the delivery of end-of-
life care involves bereavement care, it is reasonable to suggest
that those who provide this should be trained and supported
before undertaking the role.This would include maintaining a
professional manner while understanding the complexities of
bereavement care, being skilled in delivery, and reflecting using
a theoretical perspective (Bereavement Services Association
and National End of Life Care Programme, 2011; Chang et
al, 2012).
The National Council for Palliative Care (NCPC) set up
the Dying Matters Coalition to promote public awareness
of dying, death, and bereavement (Shucksmith et al, 2013).
They identified an increasing need to normalise death and
dying, with a desire to give the dying and their relatives more
control and choice, including preferred place of death. A
good death/dying well is believed to give people choice and
dignity and a better outcome for bereavement (Shucksmith
et al, 2013).
The author and participants in this study play a significant
role in providing end-of-life care, with strict guidance policies
in place to ensure it is individualised and effective toward the
recipients needs. However, there is no set guidance toward
bereavement care or a standard approach of when to com-
mence it, the number of follow-up visits, or when to refer
on and cease its provision. The main aim of the study was to
ascertain district and community nurses perspectives on pro-
viding bereavement care/support. It is the hope that this study
will uncover the answers and provide an in-depth account of
district nurses perspectives on the importance of bereavement
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care, whether they feel adept to deliver the care, and if a stand-
to its importance and improved confidence toward its delivery.
ard of provision needs to be established.
KEY WORDS
w bereavement w palliative care w education w interview
Design
Bereavement is a unique and individual experience. In
w qualitative research
order to allow both the participant and researcher to

494 British Journal of Community Nursing October 2015 Vol 20, No 10

PALLIATIVE CARE

explore further into the questions (Table1) and create an
in-depth account of their experiences, the qualitative para-
digm was the chosen methodology. The approach was of
a phenomenological stance that analyses peoples percep-
tions or meanings, attitudes, beliefs, feelings, and emotions
(Denscombe, 2014).
Sample
Purposive sampling was used to identify five nurses with
a district or community nursing background. The inclu-
sion criteria consisted of significant prior knowledge and
experience of the subject, which would allow a thorough
account of their experiences. Age and gender were not
a factor; however, the participants needed to have over
2years experience of community nursing, as more experi-
enced nurses would have undertaken some palliative nurs-
ing. The sample size was deliberately kept small, owing to
the volume of data that would need to be transcribed, and
because a large sample size within a qualitative study could
lead to repetition of data (Parahoo, 2014). According to
Denscombe (2014), specific people or events deliberately
selected (purposive sampling) are seen as instances that are
likely to produce the most data. The determinant was to
acknowledge whether district and community nurses had
sufficient skills and knowledge to provide effective bereave-
ment care and explanations for their responses to the pro-
posed questions (Table1).
Ethics
Ethical approval was sought from the University of Chester
and the authors previous NHS employment. A complete
description of the research and objectives was sent to each
participant, enabling them to make an informed choice. All
participants signed a consent form to take part in this study
and have their interview recorded.Anonymity was maintained
throughout the research, and no participating nurse will be
identified within this article.
Data collection
A semi-structured interview style was chosen for data collec-
tion. This is considered a dominant form of data collection
within a qualitative study (Braun and Clarke, 2013), although
unstructured interviews are exploratory and set to gain an
in-depth point of view from the participant without much
influence from the researcher/interviewer (Ellis, 2013). Semi-
structured interviews provide participants the scope to raise
their own questions and explore further into the discussion,
while the researcher still maintains control of the interview
(Bowling, 2014; Parahoo, 2014). This method was the most
appropriate to gain a thorough account of the participants
experiences, as it also allowed them to feel free to discuss
related issues. As the topic of bereavement is of a sensitive and
personal nature, freedom to discuss was paramount to this
research. The questions focused on the topic and the style
accommodated any new evidence of forgotten knowledge
to emerge. An expansion of the participants views on their
provision of bereavement care was sought, and any barriers
they may have perceived orencountered.
Data analysis
Verbatim transcription was carried out to ensure thorough
analysis and error from loss of data. Analysis of a phenomeno-
logical study is usually thematic in nature and placed together
to create an essence of the phenomena (Burnard et al, 2008;
Parahoo, 2014). Hence, thematic analysis was used.This involved
identifying patterns/trends within the data and linking them
as representative of the same phenomena, which can occur
several times (Gibbs, 2010).Transcription and interpretation of
data were made easy by the use of themes rather than question
numbers. Not all transcripts stated the same theme, but made
reference to it; therefore, relationships between themes were
identified and categorised accordingly. Looking for missing
data or hidden meanings is another process of thematic analysis,
as what you might expect to be there may be of significance
even if it is not talked about (Gibbs, 2010).

Table 1. Proposed questions for this study

No. Question

1 What experience of bereavement counselling have you had?

2 Do you feel that you have had enough, if any, training in providing bereavement counselling? (If yes, what? If no, do
you think you should?)

3 Do you think it is part of your role? If not, whose role do you think it should be?

4 When do you think bereavement counselling should commence?

5 How long in your opinion should the district nurse provide bereavement counselling for?

6 Do you know who and when to refer onto another service?

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7 Do you know where to obtain advice and guidance on bereavement counselling?

8 What do you think works well for bereavement care?

9 Do you think you get too involved?

10 Do you think having personal bereavement helps with undertaking bereavement care?

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Each transcript was analysed and compared to extract any
form of meaning or common theme. This lengthy process
involved listening to the audio recording throughout the proc-
ess and using any notes made to interpret any occurrences.
Complete immersion of data was required and all common
themes were generated once data saturation was reached.
Findings
Several drafts of themes and sub-themes materialised and
were merged; these were consolidated and contextualised
(Table2). Each sub-theme was incorporated under a main
theme and related to excerpts from the data.The findings from
themes1and 2 appeared to merge as they produced similar
answers, as theme 1 was also dependent on theme 2.
Main themes
Time management
All participants experienced bereavement care to be time
consuming, requiring lengthy visits, with limited time or
capacity for it to be an ongoing process. All participants high-
lighted the relevance of providing bereavement care, but felt
the need to pass it over to a suitably qualified or experienced
professional when they needed more help. The bereavement
care was also done on an individual basis and not all required
follow-upvisits.
You have to know when to stop and pass on to
other services ... bereavement can go on for years, I
wouldnt be able to offer what a bereavement coun-
sellor could it becomes out of our capabilities.
[Participant 5, Question 3]
for the nurse to detach from certain families if they have been
on the caseload for a long period of time; closeness and con-
nection invariably develops. When children and young fami-
lies are involved, some participants found it especially difficult
to not get too involved, as emotions take over and sometimes
they get dragged into family disputes. Conversely, it is easier
to be detached if the patient and family have not been known
for a long period, but this can affect the level and support of
bereavement care.
Palliative care can be up to one year you develop
that closeness and continue BC [bereavement care]
I suppose its still a connection to their dead
relative however if youve only known them for
a short time its easier not to get attached. [P3,Q5]
Building up relationships, getting to know the
patient you then have that rapport to automatically
give BC providing the family with that network
of support. [P3, Q3]
You have to be careful not to get too involved as it
could affect you and you could end up grieving for
every lost patient. [P4, Q10]
It doesnt help when you see people at the very end
you havent got that connection you have to
Table 2. Final themes and sub-themes derived
from the interviews
Number Main theme Sub-theme

Once the patient dies some [the family] dont want 1 Time management Time consuming/long periods
to know others want you there all the time Capacity/caseload/balance
you may think its not needed, but they do its
about getting the balance right for both . we dont Follow-up call (phone/visit)
have enough time to keep attending we have 2 Case specific/ Relationships/involvement
other patients to see and a large caseload.We dont attachment
have the capacity to continue a high level of sup- Attitudes/approach
port. [P1, Q5]
Individual assessments
Some want you all the time we do 1 post Younger families
bereavement visit, its rare to do anymore after
we dont have the luxury to spend time with the 3 Interprofessional Increased awareness
patient its horrible to feel you are rushing some- working
Guidelines (Department of Health, National
one you know you have other patients to see. Institute for Health and Care Excellence, or
[P3, Q5] NHSTrust)

They may only need 1 or 2 visits, time is not an Communication

issue then no time can be placed it is ulti-
4 Role/scope Ability/capability
mately the decision of the family it should con-
tinue through the dying phase then shortly after, Challenging/draining/exhaustive
then thats it. Sometimes a follow-up phone call
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may just be required. [P4, Q5] 5 Experience/ Training/theory (ongoing)/skill

learning
Confidence/exposure/reinforcement
Case specific/attachment New knowledge
Relationships and involvement include connection, rapport,
Empathy/interest
and being close to the patient, carer, and family. It is difficult

British Journal of Community Nursing October 2015 Vol 20, No 10 497
PALLIATIVE CARE
know a bit about the patient first in order to provide
efficient care cant always work to the best term bereavement care. Acknowledgment of support from
interests of the patient and family. [P2, Q3]
One participant became quite emotional during the inter-
view, on recalling the time they got too close to a patient.
I became too involved and too close one time when
a lady asked me directly:Am I going to die?... it
was a big responsibility, she could then get on and
organise her life. [P1, Q9]
Continuity of care from the same community/district nurses
attending the patient and family/carers established trust early
on; this helped toward building a professional relationship and
identifying early complications. Families can also get very
attached to the nurse, which is not healthy as it could stop
them from moving on because the nurse can be a constant
reminder of the difficult time they experienced.
Usually the same face/DN [district nurse] going
in to build up that rapport patients can get too
attached to you which is not healthy cant get
on with everyone reassurance from the same DN
as they will be able to notice a difference. [P4, Q5]
Depends upon the individual of when to stop
discussion between the DN and family some-
times they request you not to go in as you are a
reminder. [P1, Q5]
As long as they need it however too much can
be detrimental to the family if they become too
attached you know they need more professional
help. [P5, Q5]
Providing bereavement care is determined on individ-
ual need; at times, how much to provide and commencing
and ceasing the support can become problematic. Also, the
approach and attitude toward the dying patient and family can
have a detrimental effect.
BC should start as soon as someone has a terminal
illness/going to die. [P3, Q4]
As soon as you and patient see fit each individ-
ual is different depends on how responsive they
are BC commences before patient dies. [P2, Q4]
By discussing preferred place of care you have
started that conversation preparing the family
start BC as soon as possible. [P1, Q4]
Common knowledge to start BC as soon as a pal-
liative patient comes onto our books. [P4, Q4]
Interprofessional working
Increased awareness of other specialities, local and nation-
al, involved in palliative and bereavement care came with
experience. However, in this study, each participant felt
498 British Journal of Community Nursing
underqualified and lacked the expertise to provide long-
other services and policy drivers was made. Communication
between other services, such as Macmillan and GPs, increased
awareness toward bereavement care.
When you feel they are getting too reliant you
have to know the services in your area you get
info from a death and dying booklet that we should
be giving to patients to help prepare them.
[P1, Q6]
We know who to ring GSF [Gold Standards
Framework] meetings we get a lot of info and liaise
with other services improves professional rela-
tionships shared care team work. [P3, Q7]
More structured now lot of interlinking of serv-
ices GP, MN [Macmillan Nurse], etc. a lot
of communication and referring work as a team.
[P5, Q7]
Role/scope
All participants considered bereavement care to be part of
their role and concomitant with palliative care.The provision
can become challenging, exhaustive, and draining, especially
if it is over a long period of time.
I wouldnt say its not our role we do bereave-
ment support however, bereavement can go on for
years I wouldnt be able to offer what a counsel-
lor could out of our capabilities. [P5, Q3]
It is our role but we may need support ourselves
cant be there all the time to know when we
are out of our depth and to stop! [P4,Q3]
We are counsellors of such but you have to know
quite a bit about them, if you dont it cant always
work efficiently just going in and caring is start
of counselling. [P2, Q3]
Experience/learning
Learning while on the job and through experience from others
was just as valuable as obtaining outside training. Knowledge
of and understanding the theories behind bereavement helps
toward effective delivery, but does not prepare a nurse for
every eventuality. All participants had some form of training,
but stated it was ongoing, and all nurses must adapt and access
the resources available. Experience improved confidence,
and personal experience of bereavement increased empathy
andcare.
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Study days involving basic theory of bereavement
on the job training useful to have more train-
ing into theory ... continuous learning we would
know the signs to look out for if we had the proper
training. [P1, Q1 and Q2]
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A lot of training through the years I have
enough skills and experience to continue care
attended study days it doesnt make you an
expert. [P5, Q1 and Q2]
I have enough knowledge to recognise signs of
bereavement training gives you basics of what
to recognise doesnt always prepare you for every
eventuality. [P2, Q2]
Yes, but you have to be detached, otherwise you
may find yourself experiencing bereavement in some
way not good as you have to be professional.
[P3, Q10]
Having a personal bereavement makes you more
empathetic, you have compassion instinctively.
[P2,Q10]
Definitely you empathise more and understand
what they are going through. [P1, Q10]
Discussion
This study explored the perceptions of five community/dis-
trict nurses providing bereavement care. The purpose of this
study was not to generalise the findings, but to increase aware-
ness to other district nursing groups. In particular, reflect-
ing the findings of previous research (Wimpenny et al, 2006;
Smith and Porock, 2009) highlighting the importance of pre-
bereavement care and how it can improve recovery and reduce
the need for follow-up support after death.
All participants considered bereavement care to be time
consuming and stressful when undertaken as follow-up visits
and scheduling them into their workload, but not so when
performed in conjunction with the palliative care visit. This
was congruent with previous research findings about the
added pressures and stresses district and comminity nurses face
when providing palliative care (Walshe and Luker, 2010).Time
constraints and workload pressures influenced attitudes toward
palliative care in the home, owing to extra time having to be
spent against the time with a more generalist caseload (Smith
and Porock, 2009;Walshe and Luker, 2010). It also strained the
transition from palliative care to routine areas of care (Burt et
al, 2005); moreover, having a heavy workload can impinge on
a second visit (Brownhill et al, 2013).
Getting the balance right was another concern raised. It
is very challenging, but it has to be right for both the nurse
and patient/relative, and it becomes a huge responsibility as
the relative can see you as a constant reminder of the patient.
Brownhill et al (2013) also found that families forever associate
the nurse with their deceased relative.
This study found that it was rare to do more than one
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bereavement visit; sometimes only a phone call is required,
as the relatives request you not to go in. However, some
participants found it difficult when young family members
are involved, and they could not help but get too attached.
Emotions then took over, and subsequent visits occurred.
Chang et al (2012) found that follow-up visits can be both
British Journal of Community Nursing October 2015 Vol 20, No 10
PALLIATIVE CARE
beneficial for community nurses as well as the family, as the
community nurse may also experience bereavement, espe-
cially if the palliative phase has been over a long period and
relationships developed. Closure is then needed. In contrast,
Lyttle (2005) stated that getting too attached or involved could
become problematic and cause the district nurse to experi-
ence burnout.
Participants also expressed that knowing the family and
building a rapport with them would help in the identifica-
tion of any problems should they arise. If the palliative phase is
short, then the connection is not made and complications may
not always be recognised. When the family gets used to the
same nurse visiting, for reassurance they become more recep-
tive; relatives can also get too attached, which is not healthy.
The family also needs to recognise that the nurse is there for
the dying patient, and not just for relatives and carers (Mallon,
2008). According to some participants, sometimes relatives
have to be left to their own devices or referred on, especially
if both parties are getting too involved; otherwise, they would
end up grieving for every lost patient.
Increased awareness of other roles and specialities involved
in palliative and bereavement care came from experience and
awareness of whats available within their area of work. The
knowledge of other services and supporters were known to
all participants, but it was evident that the district nurse was
the one who was mainly involved, as other services, such as
Macmillan nurses and GPs, tended to step back once the
community/district became involved. All the participants
stated they did not feel qualified or have the expertise to
carry out long-term bereavement care; hence, they would
refer the families/carers on to a support group or special-
ist counsellor, as soon as possible, thus reducing pressure
andstressors.
Regular meetings, multidisciplinary teams, and implement-
ing the Gold Standards Framework (GSF) in the authors and
participants workplace created greater awareness of pallia-
tive patients,. This encouraged joint working practices and
increased support for patients and relatives. Identification of
any problems were thus shared between services. Burt et al
(2005) found that strong communication skills between serv-
ices led to improved quality of care and effective coordination
of work. Following a distance-learning, practice-based training
programme called Going for Gold into the foundation level
of GSF, seven GP practices demonstrated success in several
areas, including improved carer assessment and bereavement
care (Office for National Statistics, 2012). The training pro-
gramme also included practice updates and helped the GP
practices meet national policy targets.
All participants considered bereavement care to be part
of their role, but felt that it was out of their capability and
expertise when it was over a long period of time. All had
some degree of trainingstudy days and on-the-job expe-
rience in bereavement care. One participant assumed that
stages of bereavement are experienced after the death; there-
fore, the community/district nurse would not witness any of
it. However, according to Mallon (2008) and Kbler-Ross
(2014), the stages of bereavement can be experienced pre-
death as well as during the dying phase. This participants
499
PALLIATIVE CARE
assumption could be down to a lack of experience in pallia-
tive care and the theoretical underpinnings.
What was apparent from the findings is that bereavement
theory, that is, knowing the stages and types, helps with the
background of bereavement care and frameworks help with
the delivery of effective care. This can determine what the
bereft need, whom they need support from, and to what
degree. Training was stated to be ongoing, as it constantly
changes in addition to new experiences; therefore, the nurse
must adapt and access the resources to obtain new knowledge.
It is not the case for all community/district nurses to receive
training in bereavement care, as Momen et al (2012) found
that both GPs and community/district nurses received educa-
tion and training in end-of-life care, but with the exception
of bereavement care.
Having empathy and an interest in bereavement care
helps with the support given. Participants who experi-
enced a personal bereavement stated it does help toward
the care, as it makes you more empathetic; however, you
have to be careful not to make it about yourself and should
remain detached. Lyttle (2006) concurs it can be seen as
an advantage when delivering bereavement care. However,
experiencing a personal loss can be problematic for com-
munity/district nurses as they may find they have little
time for themselves and others, as a result of becoming too
involved (Lyttle, 2005). One participant discussed experi-
encing a personal recent bereavement as being a factor to
not undertake any palliative care on returning to work.
Performing bereavement care could become overwhelm-
ing and hinder them from doing the job effectively, as they
would be constantly reminded of their own bereavement.
They could return to this role when they feel ready and
have a good support network. Education at both pre- and
post-registration would help identify any personal issues of
grief (Nagraj and Barclay, 2011).
Limitations
The use of a single method of data collection and one
researcher meant there was no triangulation, and the data
were subjective in nature.The interpretation was exclusively
the researchers, although every effort was made to reduce
bias.The style and wording of the questions may have inad-
vertently suggested the themes as they could be interpreted
as leading the participants to answer in a pre-determined
manner. There is a risk that this research could have been
lead in a direction associated with the researchers personal
view. However, this method and questioning was intentional,
to address any gaps in knowledge identified in the literature
review carried out by Johnson (2015). A comparable analysis
was thus easier to conduct. In addition, as certain themes may
have been pre-suggestive, a grounded theory approach using
inductive and deductive reasoning may have produced more
substantial results, thus allowing a multidimensional view of
the phenomena (Parahoo, 2014).
Questions 1 and 2 (Table1) produced similar answers.They
were therefore combined within the findings. This may have
suppressed additional themes from emerging from the data.
However, if a similar study was to be conducted over a longer
500 British Journal of Community Nursing
period with an alternate phrase of questioning, this shortcom-
ing may be avoided.
This research was guided by the literature review and
undertaken because of a lack of previous study into this area;
therefore, the comparisons were limited.The sample size was
small and contained within one geographical area, which was
also the researchers place of work. This could have poten-
tially influenced the transcribing and findings.The author has
attempted to be clear on the professional relationship they had
with the participants and exclusion of any personal views, in
order for the reader to be aware of any potential inherent bias.
Conclusion
Bereavement care is an important aspect of palliative care;
however, it is not as great as other parts of the community/
district nursing role. This was evident in the limited time the
participants stated they spent on its provision. Breavement
care can be unpredictable and complex for the district nurse,
be it a swift or long process, resulting in continuous adjust-
ment of the caseload to compensate for changes. It would be
beneficial to have clarity into the scope for the community/
district nurse with regard to bereavement care provision.The
author accepts that this clarity in itself is difficult, as each situ-
ation has an inherent level of ambiguity with regard to when
bereavement care not so much begins, but when it should end.
No definitive answer surfaced to a standardised approach
or the number of post-bereavement visits/phone calls needed
from the community/district nurse, as its based on individual
need and assessment. Bereavement care could be ongoing, or
not commence at all, as it can start as soon as the palliative
phase begins or according to the patients/relatives receptive-
ness toward it.
Training and knowledge into the theory of bereavement
care were thought to be helpful in recognising the signs and
types of bereavement, in order to determine the approach to
effective care delivery. It could also assist in reducing the risks
associated with bereavement, prompting the district nurse to
seek assistance or refer to appropriate specialist services.
All the identified themes were interlinked, as experience
teaches you to become detached and how to deal with dif-
ficult situations. It enhances capabilities and knowledge of
other specialities. Confidence and exposure increases aware-
ness and improves delivery of care and develops professional
relationships with patients and members of the multidisci-
plinary team.  BJCN
Accepted for publication: 22 September 2015
Declaration of interest: The author has no conflicts of interest
todeclare.
Note:A literature review on the subject of bereavement care and sup-
2015 MA Healthcare Ltd
port, written by the same author and published earlier this year, can be
found here: http://dx.doi.org/10.12968/bjcn.2015.20.6.272.
Bereavement Services Association and National End of Life Care Programme
(2011) When a person dies: guidance for professionals on developing
bereavement services. http://bsauk.org/uploads/834766631.pdf (accessed
22 September 2015)
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Fundamental Aspects of
Palliative Care Nursing 2nd edition About the book
All nurses are intimately involved
student nurses it is widely recogni
towards their particular needs
in caring for the dying and bereave
sed as one of the most challeng
d at some point in their career
ing aspects of their role. This book
and for
Fundamental Aspects of
and the difficulties that student is centred
nurses face when confronted

Palliative Care Nursing

how to use the palliative approa with the reality of
Robert Becker
ch in the multiple environments
skills. This second edition maintai in which they are expected to
Fundamental Aspects of Palliative Care 2nd

ns a sensitive and supportive approa develop their

This title presents a sensitive and
nursing, but contains important ch to the key themes of palliativ
new material of a wide range e care
care across the UK. It will provide of initiatives that are impacting
the reader with a concise, easy on end of life
give advice and direction to the
Reflective activities and points for
many challenges faced in this most
to read and learning oriented
text that will

An evidence-based handbook for student nurs

important area of patient care.

supportive approach to the key themes Each chapter examines a key

professional development
component of care and is structu
red to include:
es
of palliative care nursing.
Learning outcomes to guide

It contains important material on a wide
range of initiatives that are impacting
2nd edition
the reader
Clinical anecdotes to illustrat
Links to appropriate clauses
Reflective activities and points
e the reality of practice
for professional development
Links to appropriate clauses
Internet resources of the NMC Code of
of the current 2008 NMC Code
of Professional Conduct
Self assessment tests at the Robert Becker
A palliative care quiz to test ProfessionalConduct
end of each chapter to consoli
your knowledge
date learning

on end of life care acrossassistan

the
The book willUK. Each
also prove useful to newly qualified nurses,
ts in many care settings. Selfthoseassessment tests
returning to practice and health
care at
chapter examines a key component of
About the author the end of each chapter to
care and includes: Robert Becker MSc Dip N (Lond)
Care joint teaching appointment consolidatelearning.
RMN RGN Cert Ed (FE) FETC
between Severn Hospice in Shropsh
730 holds a Senior Lecturer in
Palliative
of Health based in Shrewsbury. ire and Staffordshire University
Learning outcomes tonumber guide Over the last 15 years he has
of European countries and regularl developed a teaching and advisor
y leads palliative care study tours
Faculty
y role in a
He is Chairperson of the Nation for health profess
the reader editoria
al Association for Palliative Care
l board of the International Journal Educato rs
ionals in China.
and is an active member of the
the Year Award at the International ISBN-13: 978-1-85642-394-6;
of Palliative Nursing. He is also
Journal of Palliative Nursing Awards
a recipient of the Educationalist
of
for 2008.
Clinical anecdotes to Othe r titles in the Fundamental 234x156mm;paperback;
illustrate Aspects s: of Nursing serie
the reality of practiceCommu Procedures 360pages;publication2010;
Children & Young Peoples Nursing
edition

nity Nursing Mental Health Nursing

Complementary Therapies Nursing Adults with Respiratory
Disorders
Finding Information Nursing the Acutely Ill Adult
This book is a thoughtful and thought provoking text and will be a useful
Long-Term Conditions Pain Assessment & Management
Research for Nurses
addition to the library of anyone teaching or taking palliative care courses
Series Editor: John Fowler

or placements in end-of-life care settings.

Robert Becker

ISBN 1-85642-394-8

Dion Smyth, The International Journal of Palliative Nursing

2015 MA Healthcare Ltd

9 781856 423946
Fundamental Aspects of Nurs
www.quaybooks.co.uk
ing series
Order your copies by visiting or call our Hotline
www.quaybooks.co.uk FA PalliCare2nd cover.indd
1
+44(0)1722 716 935
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