Center to Advance Palliative Care

There are several different models for use of palliative care NP's. Several programs use them on a nurse led team with a collaborating physician available. Some programs use the NP on a team along with a palliative physician and/or medical director. When there is a palliative unit having a medical director is very helpful to establish the unit as a speciality unit with expertise. It also identifies who the go-to person is for difficult conversations/discussions with physicians and complex symptom managment. It also lends administrative clout to the unit. An important element with any team is that there are routine processes and tools to assure care coordination, interdisciplinary collaboration and high quality care. At Mt. Carmel we have daily rounds-M-F- on the unit with an expanded IDT meeting every week. The daily rounds are attended by the physician/NP, MSW, chaplain, RPh and staff nurse. The plan of care is then reviewed, patient seen and family conversations/meetings are held. We also have a physician available 24/7 for complex symptom issues. On the weekends we have physician on-call for new consults and to see complex patients as needed. The NP can be a primary care provider, physician extender, or function in a nursing collaborative/leadership role.

Best wishes starting your program.

Sharol Herr, RN, MSEd, CHPN
Nurse Clinician/Education Coordinator
Mt. Carmel Health--A CAPC Palliative Care Leadership Center
Columbus, Ohio