Nurse Practitioners (NP) work in many roles in residential aged care: general primary care, wound care, memory disorders, mental health, heart failure and palliative care.

A Nurse Practitioner is a Registered Nurse who has completed both advanced university study at a Masters Degree level and extensive clinical training to expand upon the traditional role of a Registered Nurse. They use extended skills, knowledge and experience in the assessment, planning, implementation, diagnosis and evaluation of care required.

As far as I know, I am still (unfortunately) the only specialist palliative care nurse practitioner employed by an aged care provider in Australia. Why is that you ask? Primarily it comes down to money. NP services are not funded via the aged care funding system (ACFI), and the income I can generate from bulk billing residents via Medicare covers only a small proportion of my salary. So it relies on an organisation like Resthaven seeing the non-monetary benefits and improved outcomes that stem from a role like this. 

The reality for some time in respect to continuing to provide quality health care is “Work smarter not harder”.  The health dollar is becoming like a Northern White Rhinoceros , still in existence but rare. There is ever increasing scrutiny about how both of these prized possessions are used and treated. Continued investment is regularly linked to reportable outcomes, whether it be in the case of the Rhinoceros an increase in their numbers or for the health dollar reduced overall cost.  You are more likely these days to find the CEO of a hospital having an MBA in hospital administration than being a senior clinician. As this is a reality we need to develop strategies / programmes that do have clinically reportable outcomes that they will comprehend.

Aileen Collier is a lecturer in Palliative and Supportive Services, Flinders University. Her research sits at the interface of social science and health research and is focused on human agency and safety and quality of palliative care. She also teaches in the Flinders University post-graduate program.

What advice can I offer you about nursing, research and improving health care?  Nurses, as the backbone of our health services, need to be highly responsive to direct patient care needs. If improvements in palliative care are to be realised however, we also need to enact what colleagues Jane Phillips and Meera Agar have recently described as “exemplary leadership”.  Our health care systems are complex, in constant flux and driven by efficiency and cost effectiveness.  We need to take an active role in policy development as well as critically adapting ‘top-down’ policy and evidence-based initiatives within local settings. In this environment, nurses simply cannot afford not to be able to make sense of research findings.
 

Health professionals can find it difficult to manage the growing evidence relevant to the care of patients with palliative care needs. While CareSearch provides access to a wide variety of palliative care evidence and resources, knowing which one to use can be tricky. Recognising when it might be worthwhile looking for additional evidence is also important. These were the original reasons why we introduced My Learning, a web-based learning initiative, in 2012.  Educational modules in My Learning introduced health professionals to resources in CareSearch and showed how they could help in clinical care and decision making. Since then, each month, around 100 people complete the learning modules.
 

The Fourth International Conference on Grey Literature (GL '99) in Washington, DC, in October 1999 defined grey literature as ‘that which is produced on all levels of government, academics, business and industry in print and electronic formats, but which is not controlled by commercial publishers’.

Grey literature can include material that is not conventionally published and may be hard to find and sometimes ephemeral. It is not indexed formally in major databases and requires general web searching using a search engine such as Google. It can include such items as government reports and documents, state-of-the art reports, market research reports, theses, conference papers, technical specifications, and standards.