Are specialist heart failure nurses currently able to provide palliative care to their patients?

Introduction: A diagnosis of heart failure is associated with a high burden of multidimensional problems including pain, breathlessness, and depression as well as poor prognosis. This study aimed to describe the current palliative care skills and knowledge of specialist heart failure nurses. Methods: A cross-sectional self-report survey was conducted. All British Heart Foundation specialist heart failure nurses in the UK were invited to participate. The mixture of open and closed questions addressed current knowledge, provision, and training needs. Results: A response rate of 65% (n=91) was achieved. The vast majority (85%) identified first-line pain management in line with the World Health Organization pain ladder, although this reduced to 68 and 44% for second-and third-line treatments. Specific problems that the respondents appeared to knowledge of lay in the management included depression and constipation. Their self-identified training needs focused principally on communication and the introduction of palliative care into patient management. Discussion: Further skill training is recommended specifically on appropriate drugs for the management of common pain and symptoms among heart failure patients. Further, additional support in initiating and conducting 'sensitive' conversations is required. In order to improve outcomes for patients with heart failure, integration, and exchange of expertise is required between cardiology and palliative care.