Premium
A practice model for rural district nursing success in end‐of‐life advocacy care
Author(s) -
Reed Frances M.,
Fitzgerald Les,
Bish Melanie R.
Publication year - 2018
Publication title -
scandinavian journal of caring sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.678
H-Index - 66
eISSN - 1471-6712
pISSN - 0283-9318
DOI - 10.1111/scs.12505
Subject(s) - nursing , end of life care , context (archaeology) , palliative care , feeling , psychology , medicine , social psychology , paleontology , biology
Aim The development of a practice model for rural district nursing successful end‐of‐life advocacy care. Background Resources to help people live well in the end stages of life in rural areas can be limited and difficult to access. District nurse advocacy may promote end‐of‐life choice for people living at home in rural Australia. The lack of evidence available internationally to inform practice in this context was addressed by exploratory study. Method A pragmatic mixed method study approved by the University Faculty Ethics Committee and conducted from March 2014 to August 2015 was used to explore the successful end‐of‐life advocacy of 98 rural Australian district nurses. The findings and results were integrated then compared with theory in this article to develop concepts for a practice model. Results The model illustrates rural district nurse advocacy success based on respect for the rights and values of people. Advocacy action is motivated by the emotional responses of nurses to the end‐of‐life vulnerability people experience. The combination of willing investment in relationships, knowing the rural people and resources, and feeling supported, together enables district nurses to develop therapeutic emotional intelligence. This skill promotes moral agency in reflection and advocacy action to overcome emotional and ethical care challenges of access and choice using holistic assessment, communication, organisation of resources and empowering support for the self‐determination of person‐centred end‐of‐life goals. Recommendations are proposed from the theoretical concepts in the model. Limitations Testing the model in practice is recommended to gain the perceptions of a broader range of rural people both giving and receiving end‐of‐life‐care. Conclusion A model developed by gathering and comparing district nursing experiences and understanding using mixed methods and existing theory offers evidence for practice of a philosophy of successful person‐centred advocacy care in a field of nursing that lacks specific guidance.