CANADIAN HOSPICE PALLIATIVE CARE NURSING STANDARDS
The World Health Organization (WHO) 2005, which describes palliative care as:
an approach that improves quality of life of clients and their families facing the problem associated with life-threatening illness, through the prevention of suffering by early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual. The HPC nurse maintains and conducts practice in a manner that is consistent with the CNA Code of Ethics, provincial standards, territorial standards and CHPCA guiding principles and foundational concepts.
The following standards are in addition to this and are specific to HPC nursing. Ethical and collaborative practice is embedded throughout the provision of HPC.
1. Quality of Living-Dying
The HPC nurse focuses on the quality of the experience of the person who is living with and dying from a life-limiting illness, as well as the experience of the family. The HPC nurse practises with respect for the personal meanings, specific needs and hopes of the person who is living in the last phase of his/her life and his/her family.
The HPC nurse utilizes a knowledge-based, systematic, holistic and evolving approach to address symptoms and issues specific to the living-dying experience.
The HPC nurse provides care throughout multiple illness trajectories of life-limiting illnesses, which may occur over a short period of time (sudden death) or may be a longer process (exacerbations of chronic illness or recurrences of cancer). The HPC nurse supports the individual and his/her family through these transitions, the dying process and throughout the grief and bereavement processes. The HPC nurse assists persons and families to access and navigate the health-care system.
4. Quality and Safety
The HPC nurse practises in accordance with legislation, policies, guidelines and tools pertaining to assessment, information sharing, decision-making, advance care planning, pronouncement of death, after death care, and grief and bereavement support.
The HPC nurse advocates for and promotes high quality and safe palliative care. The HPC nurse advances HPC nursing through the generation and application of knowledge and research. The HPC nurse is an essential team member of the interprofessional team and establishes collegial partnerships and contributes to the professional development of students, peers, colleagues and others through consultation, education, leadership and mentorship.The HPC nurse communicates and advances the distinct contribution of nursing to the interprofessional team.
6. Personal and Professional Growth
The HPC nurse recognizes the privileges and challenges of working with persons who are living-dying and their families. The HPC nurse understands his/her own personal experience in response to suffering and death. The HPC nurse recognizes his/her personal needs and practices self-care while experiencing multiple losses during the care of persons who are dying and their families
• provides relief from pain and other distressing symptoms;
• affirms life and regards dying as a normal process;
• intends neither to hasten or postpone death;
• integrates psychological and spiritual aspects of client care;
• offers a support system to help clients live as actively as possible until death;
• offers a support system to help the family cope during the client’s illness and in
• uses a team approach to address the needs of clients and their families, including
bereavement counselling if indicated;
• will enhance quality of life, and may also positively influence the course of illness;
• is applicable early in the course of illness, in conjunction with other therapies that are
intended to prolong life, such as chemotherapy or radiation therapy, and includes
those investigations needed to better understand and manage distressing clinical