The challenging experience of palliative care support-team nursing.

The purpose of this study was to document the experience of palliative care nursing as a part of a multidisciplinary support team. Data were obtained from two palliative care support-team nurses. Each nurse privately recorded on audiotape any reflections about particularly meaningful aspects of her daily work experience; in-depth interviews with the two nurses together also were used for data collection. Inductive analysis elicited previously identified dimensions of palliative care nursing, including the support and coordination functions provided to other health professionals. The palliative care support-team experience included many challenges associated with the ultimate outcome of death; restricted and unpredictable time frames; and greater demands for human resources, psychosocial-care skills, and interdisciplinary, family-oriented care. These factors appeared to interact with the nurses' commitment by escalating their drive to serve others and creating both internal and external conflicts. The nurses expended considerable energy in role adaptation and in intrapersonal and interprofessional conflict management. This effort emerged as being vital to the nurses preserving their own integrity, both personally and professionally. The findings of this study may help all professionals who provide palliative care to better understand the nature of their work, themselves, and each other. Strategies to promote understanding may help to reduce the amount of time and energy that professionals must dedicate to preservation of integrity.