Palliative Care Nurse Practitioner Candidate
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- Augusta Stanley
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1 Palliative Care Nurse Practitioner Candidate
2 Palliative Care Palliative care is an approach that improves the quality of life of patients and their families facing problems associated with a lifethreatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual WHO, 2002
3 What is a nurse practitioner Registered Nurse Advanced practice Completed a Masters Endorsed through Australian Health Practitioner Regulation Agency (AHPRA) Work autonomously and collaboratively Diagnostics Prescribing
4 Why do we have nurse practitioners in palliative care? Changing health needs of community/ shortage of specialist palliative care staff in Gippsland Nurse Practitioners offer improved access to palliative care services for symptom management Aim to improve quality of life for patients, their families and carers Link/ support for General Practitioners Resource to others in the team Clinical expertise and mentorship Involved in research and leadership in palliative care Refer to other services
5 What is a nurse practitioner candidate? Registered nurse working towards endorsement as a Nurse Practitioner Work within a speciality Academic and clinical requirements Clinical supervision and mentorship significant in the development of the candidate
6 Nicola Gorwell Gippsland Lakes Community Health18-28 Jemmeson Street Lakes Entrance, 3909 Jo Kelly Bass Coast Community Health Service1 Back Beach Rd San Remo, 3925 Jenny Turra Latrobe Community Health Service Buckley Street Morwell, 3825
7 My Role Employed by Latrobe Community Health Service and funded through Latrobe Community Health Service and Gippsland Region Palliative Care Consortium Subregional role, Central West Gippsland Memorandum of understanding with Latrobe Regional Hospital The focus of the Memorandum of understanding, is to provide opportunity for improved care and collaboration of services and to support the Palliative Care Nurse Practitioner Candidate. Work with the consultancy team from Calvary Health Care Bethlehem (CHCB)
8 What have I been doing? Palliative care clinic Latrobe Community Health Service; Palliative care clinic William Buckland; Monthly ward round with Calvary Health Care Bethlehem (CHCB) consultancy team Latrobe Regional Hospital Facilitate Multidisciplinary team meeting Review/ provide recommendations for complex cases in community Palliative care working group party Latrobe Regional Hospital Clinical network Triage tool, Department of Health Mentorship program, Department of Health
9 Clinical Practice Group, Gippsland Palliative Care Consortium Ward rounds Nicholson neurological musculoskeletal examination/ Emergency Department physical assessment/ Macalister unit Clinical at Calvary Health Care Bethlehem Clinical with Karen Glaetzer, NP palliative care, South Australia Weekly contact with clinical supervisor, Alex Burke/ monthly contact with mentors, Karen Glaetzer and Vanessa McColl
10 Case study Mrs H 77 year old Breast cancer four years ago Extensive bone metastases one year ago Lives alone Good family support
11 Client Issues Increasing pain radiating from lumbar spine into R) sacroiliac region and down into right leg Burning/ shooting 10/10 Difficulty getting in/ out of bed Sleep Large impact on independence
12 Management at review Current pain management Hydromorphone 68 mg daily Oxycodone 20 mg PRN/ Morphine mixture 20 mg Two days prior desperate 80 mg Morphine mixture (minimal response) Occupational therapy review
13 Client Goals Independence Pain free Go away on holiday over Christmas Remain active
14 Plan D/W G.P D/W Specialist Physician Commenced Gabapentin 300 mg, titrated up to 900 mg TDS, monitor Contact with William Buckland Radiotherapy Gippsland R/V 2/7 William Buckland, proceeded to have three fractions radiotherapy to the area Monthly Zometa under care of medical oncologist Mepac alarm Ongoing review by community team
15 Outcome Reduction in pain 1/10 Increase in independence Increase in her mood Able to go away to beach with family for three weeks
16 Team approach Timely intervention and review Adding value to her management
17 Questions
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