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Leadership and Team Dynamics

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Post Nurse Driven PC
Author: Sophia
Date: Jul 28, 2010 3:30 pm
Our program is a 'nursing forward' or 'nursing driven' palliative care consult service model in a hospital setting. We have a .3 MD and would like to hear if anyone else is operating under such a model.
Thank you, Sophia
Replies: order by [Date] [Author] [Subject]
- Re:Nurse Driven PC (by Deb on 07/28/2010)
I am a nurse run PC program and have no physician at all. I work with the attendings. Consequently the majority of what I do is talk to pt's about code status, decisions about things like tube feedings, dc options and am frequently in the ICU discussing withdrawal of support. Occ an attending will ask for assist with pain and symptom management and will consider my suggestions...We do have a pharmacist run pain program here, so most pt's with acute pain are well managed. The ones I am usually asked to assist with are the more difficult cancer pain pt's. I have been lobbying for a medical director and a complete team for 5 yrs without success...
+ Re:Re:Nurse Driven PC (by Sophia on 07/28/2010)
Hello Deb-
Sounds very much like what I am doing here. I would like to connect for direct communication. Would you mind providing your email contact info?
Re:Re:Nurse Driven PC (by itriana on 09/28/2011)
Deb, I was told yesterday after few months working on designing a PCP and working towards having the best team with at least a physician champion that there won't be such a structure. I'll be working conulting the pts as they are referred to me, process that hasn't been clarified yet.I'm a nurse but not a NP as I well as you( what I understood from your posting). Please can you tell me how you get the referrals and if you have a model for consultations. Do you write orders (NP) or just leave recommendations for the primary physician. How often are they followed? Hoew do you arrange or coordiante services from chaplins or SWorkers if needed?

Your advice will be very helpful.

Thanks IT
Re:Nurse Driven PC (by mfarrarlaco on 08/08/2010)
Greetings to all of my collegues and friends out there doing the work of palliative care. Any palliative care is better than no palliative care, but we should strive for the best, not just good enough. I am a nurse and a nurse practitioner. I am an advocate for the profession and the role of nursing at all levels. I say that to say this, nurses became nurses to be nurses. Time has shown us that without a physician champion in your palliative care service, the service will stay small or die out when you get too tired to keep doing it. You need allies in good places. As much as we all want people to do the right thing, fact is hospitals are physician driven, and docs listen to other docs. Nurses will always be on the front line with their social work collegues doing the "dirty work" but without the presence of a strong physician champion opening doors, its a much tougher road.
Additionally, as in all things, once you give it away for free, its a hard sell to get someone to pay for it. Nurses, we have good hearts, our history has us on the battle front caring for people others have given up on. We have a rich wonderful heritage, and it grew up along side our physician collegues. The palliative care community needs us all.
I honor the work you are doing Sophia, thank you for the sacrifices you make for your patients every day. Margaret.

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