The Experiences of Nursing Managers in Implementing Palliative Care in Long-Term Care Facilities

Abstract

Purpose

The purpose of this study was to explore the experiences of nursing managers in implementing palliative care in long-term care facilities and to provide recommendations for managers who plan to introduce palliative care into their facilities.

Methods

This study used semi-structured interviews and grounded theory methodology, with purposive sampling. A total of 11 long-term care facilities in eastern Taiwan that had implemented palliative care were selected, and 11 facility nursing managers participated in in-depth, face-to-face interviews.

Results

The introduction of palliative care in long-term care facilities can be divided into four stages: (1) the opportunity for change, (2) playing a supportive role, (3) a new collaboration model, and (4) facility transformation. The core category shared by the participants may be summed up as “the palliative care captain in the facility”. It reflects the spirit of the successful implementation of palliative care by managers in long-term care facilities.

Conclusion

The study reveals that during the initial phases of implementing palliative care, the palliative care teams assume a crucial leadership role, while the facilities play a supportive role. At this stage, managers should focus on personnel training and addressing internal issues within the facilities to facilitate successful collaboration with the palliative care teams. In the later stages, the facilities transition from a supportive role to one of independence, marking a critical juncture for the facilities’ potential stable development. During this period, managers are tasked not only with establishing the facilities’ own palliative care team but also with facilitating the transformation of staff from learners to instructors. Finally, even after successful implementation, managers must contemplate how to innovate and set more ambitious goals.

Keywords:

• nursing managers
• long-term care
• palliative care
• hospice
• grounded theory

Data Sharing Statement

The data supporting the findings of this study are available on request from the corresponding author. The data are not publicly available because of privacy and ethical restrictions.

Ethical Approval

The study was approved by the Research Ethics Committee of Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan (Approval no. IRB108-104-B) on June 6, 2019.

Acknowledgments

We would like to thank all the participants in this study for their time and willingness to share their experiences and feelings with us.

Disclosure

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Funding

The authors receive no financial support for the research, authorship, and/or publication of this article.