Palliative care training crucial for Registered Nurses

4_11_22 palliative care training

Reforms to the aged care sector will see aged care facilities staff Registered Nurses (RNs) 24/7 to improve the quality of care, but a national palliative care peak body has said there’s a missed opportunity to improve that care even more. 

Palliative Care Australia (PCA) wants to see palliative care training embedded in aged care for all staff, particularly for RNs, and has established a plan to see this manifest.

Prior to the Federal Budget, PCA called for the Government to provide palliative care funding so that the new 24/7 nursing care reform could include mandatory palliative care training for nurses. 

However, Chief Executive Officer (CEO) of PCA, Camilla Rowland, said that their call out for compulsory training in palliative care was ignored, so they are putting their own plan forward to fix the issue.

“RNs play a critical leadership role in any health setting, but especially so in aged care,” Ms Rowland explained. 

“By the end of 2025 we’d have 8,200 nurses trained in palliative care, supporting aged care residents and their families. We see this as an innovative, common-sense way to harness the existing workforce while addressing sector-wide shortages.”

The plan is estimated to cost $36 million over four years and has been submitted to Federal Health and Aged Care Ministers Mark Butler and Anika Wells for their consideration. 

PCA’s three-step training plan would begin with RNs, but then be extended to Enrolled Nurses (ENs), allied health professionals, and other care workers within an aged care facility.

The three-step training plan includes:

  1. Building on the Government’s plan to have Registered Nurses 24/7 in residential aged care ensuring they have essential palliative care skills
  2. Fund a National Palliative Care Workforce Strategy
  3. Support the palliative care sector with a commitment to fund the peak body for palliative care in Australia

Twelve recommendations of the Royal Commission into Aged Care Quality and Safety surround palliative care and emphasise the importance of adequate end of life training being offered to workers in the sector to raise care standards.

Often palliative care is delivered in the final days of an older person’s life in aged care, but PCA believe with increased training and awareness, more holistic, person-centred care can be delivered earlier, to ensure they are comfortable and that their families can prepare for their death.

The level of palliative care training nurses receive can vary across the sector as it is not standardised, which accounts for 53,000 older people dying annually having not received adequate palliative care.

“Palliative care is all about getting the most out of the life you have left – and that can start many months and years before someone dies – not only enriching a family’s end of life experience with their loved one but reducing costs to the health system through reduced hospitalisations and a better allocation of health services,” said Ms Rowland.

Last month, a webinar was held by Melbourne Academic Centre for Health (MACH) and the Melbourne Ageing Research Collaboration (MARC) for aged care workers to help them identify a resident’s risk of dying and initiate end of life conversations.

The experts who spoke in the webinar outlined the ongoing “culture of curing” in the sector and how care staff are uncomfortable and lack confidence in discussing death with residents and their families. 

MARC End of Life Researcher, Dr Katrin Gerber, said the sector needs to address death denial and prognostic avoidance that exists in a lot of healthcare settings, which is similar to an ostrich sticking its head in the sand.

“Telling them that they might be at risk of dying and they don’t, or not telling them and then they do?”

PCA hope the Government will see the “human and economic benefits” of their palliative care training initiative and will be included in the May 2023 Federal Budget.

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