Hospital Palliative Care Clinical Nurse Specialist Impact on Doctors and Nurses

Background: Within the last decade there has been a rapid expansion in the UK of Clinical Nurse Specialists (CNS), yet there has been limited evidence of their effectiveness. Palliative care has one of the largest numbers of CNS which has particularly started to escalate in the acute hospital setting. In light of the current policy emphasis of Clinical Governance and Clinical Effectiveness, there is an urgent need to demonstrate the contribution that the CNS make. Method: This paper presents the qualitative findings from an evaluation study on the impact of the CNS within a palliative care team in a large acute university hospital in the UK. A stakeholder evaluation was used that encompassed tape-recorded semi-structured interviews, to explore how the stakeholders saw the impact of the CNS within palliative care on doctors and nurses. 27 interviews were conducted with stakeholders across the hospital setting including; senior nurses, consultants, junior doctors and nurses representing the different grades. The data was analysed for emerging themes using case and cross case analysis. Results and Discussion: The results indicated that the palliative care CNS was seen to be providing support, advice and education for the medical and nursing staff. Additionally senior stakeholders identified a potential disadvantage in the deskilling of staff. This paper will focus upon exploring these benefits as well as the potential disadvantage of hospital based palliative care CNS.