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We need specialist teams to offer quality end-of-life care

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The new focus on providing appropriate services for patients at the end of their lives outlined in the long-awaited end-of-life strategy is a welcome one. Currently, end-of-life care is primarily limited to the remarkable, high-quality approach offered in our hospices.

But this is not enough. We need a strategy to cover all locations in which patients will die, including hospitals and their own homes – and this new plan does just that. For many years the public has been asking for a choice in where they end their days.

Now they will be given that choice.

But to turn the strategy into reality across England we need to expand the specialist nursing teams, which are currently being piloted. We also need to develop the skills of individual nurses – the ability to talk openly about death is key but so is the ability to understand and respond to the spiritual and cultural needs of the different groups that make up our society.

The other challenge is how we recruit and support the nurses who will make up the new teams. We know from our experience of the hospice movement that staff who provide end-of-life care find it extremely fulfilling but also emotionally draining, even more so than general nursing. Therefore intensive training and support programmes are required for these new teams.

Allow nurses to sleep during night shifts

This week NT reports exclusively on plans to lobby the government to allow nurses to sleep during night shifts, as their doctor colleagues can.

A meeting will be held next month between unions and NHS Employers and it is crucial changes to the present system are agreed. There is plenty of evidence demonstrating the short and long-term negative impact of working nights. In the short-term, alertness is decreased and accidents more likely.

To reduce these risks we need a national strategy that allows nurses to sleep during their shifts – it is not acceptable that in some trusts this is allowed, yet in others a nurse found sleeping during their night shift can be disciplined. Employers must listen and respond positively to the unions’ lobbying.

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