Nursing and palliative care - What significance did basic nurses attach to procedures and clinical guidelines in palliative care

Nursing in palliative care is undergoing great changes in Denmark. The purpose of this study was to examine the nurses' perception and experience with clinical procedures and guidelines regarding basic palliative care, including what role such guidelines might play for the quality. Six qualitative, semi-structured interviews with nurses were conducted in order to capture the actions and attitudes towards palliative care. The analysis consisted of a systematic text condensation seeking to highlight and elaborate on key points derived from the interviews. Four main themes were identified: Procedures, clinical guidelines; The nurses' experiences and professional evaluation; The values of the nurses; and Cooperation and Communication. The study showed that the nurses attach particular values to palliative care, comprising caring, respect, presence, empathy and support to ensure hope, dignity and integrity of the patient and the relatives. Additionally, they attach great importance to the ability to keep a sense of perspective and to anticipate, prevent, perform, coordinate and lead the nursing. On the contrary, the procedures and clinical guidelines for palliative care were generally not applied. The informants found that they either did not know them or need them. The study contributes information about the nurses' perception of their professional identity, including their understanding of palliative nursing and the values they connect to it.