2022 to 2024: University of Cambridge – Dr Ben Bowers

Learning from community nurses’ perspectives of taking on extended clinical roles in end-of-life care during COVID-19. A qualitative focus group study

This multi-methods research study explored community nurses’ views and experiences of their new and extended roles in palliative and end-of-life care since the Covid-19 pandemic. An online survey of 51 UK-based community nurses was followed by focus group interviews with 35 survey participants in 2023.

Community nurses identified two particular roles that were new to many of them: verifying death and prescribing. Many nurses also talked about a broader, more fundamental expansion of their role; they described themselves as frequently replacing general practitioners and palliative specialists in making important and often complex decisions with patients and families. While nurses expressed pride in their new knowledge and skills, many also expressed dissatisfactions, particularly concerning the quantity of work now expected of them and the extent to which they now have to take the lead in managing complex clinical problems. They described heavy workloads impairing their capacity both to provide good clinical care and to train and support their junior nurse colleagues.

Recommendations:

1.     Policy-makers and commissioners need to recognise the importance of allowing experienced nurses adequate time to facilitate their juniors’ experiential learning, alongside providing high-quality care for patients.
2.     Medical back-up for community nurses managing complex end-of-life situations needs to be strengthened.