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NT talks to Gill Horn, a Macmillan lead cancer nurse in Yorkshire, on palliative care

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Reports by Marie Curie and the Royal College of Physicians have found that more needs to be done to help nurses address spirituality in end-of-life care.

Nursing Times talks to Gill Horn, Macmillan lead cancer nurse at Doncaster and Bassetlaw Hospitals NHS Foundation Trust, who agrees that nurses need more support in the area.
NT: What exactly is spirituality and how is it involved in end of life care?

GH: It is not just about religion, it is about what life has been about for the patient. Spirituality is about who the person really is, it’s about how they feel about their family, what they are going to leave behind, about the contribution their life has made, issues around forgiveness and it can even be about what is going to happen to your dog if you are not there to care for it.

It means different things to different people and it can be difficult for nurses to assess that but in the end it is about a detailed discussion and listening to the patient and helping them work with their particular issues.

NT: Why does it cause a problem for nurses who work in end of life care?

GH: It’s an area that nurses feel they do not have the skills to be able to conduct a needs assessment of.

It is difficult enough for them to explain and help them understand their illness let alone talk about what it means to their life and it is very hard to know how to open up the lines of communication about it.

NT: What can nurses do to improve things?

GH: Nurses need to be supported to think about their own spirituality first so they have thought through what spirituality means from them, and by doing that they will be in more of a position to have a few questions in their head that will help them to start having conversations with their patients and their families.

It is a difficult time but with sensitivity and training it is possible. They need to be very sensitive and be led by the patient about how far they can go with the conversation, but at the same time ask the right questions.
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