Advanced and expanded roles in palliative care nursing.
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KENNEDY, C. and CONNOLLY, M. 2018. Advanced and expanded roles in palliative care nursing. In Walshe, C., Preston, N. and Johnston, B. (eds.) Palliative care nursing. 3rd ed. London: Open University Press [online], chapter 14. Available from: https://www.mheducation.co.uk/9780335261628-emea-palliative-care-nursing-principles-and-evidence-for-practice-group
This chapter explores contemporary issues around advanced practice nursing roles and their contributions to palliative care. Our approach here is to consider advanced practice as a generic term which includes clinical nurse specialist and advanced nurse practitioner roles. These are extended roles and signify nurses who practise at a higher level than traditional nurses. The roles are shaped by the countries and context in which the nurse is practising. Our aim is to define the concepts and characteristics in advanced practice in order to provide insights into nursing contributions to palliative care. In this chapter we identify the growing demands for palliative care due to demographic changes alongside the resulting implications for education, professional identify and the scope and development of advanced practice nursing roles. We draw on evidence which demonstrates a 'blurring of professional boundaries' and 'fluid role boundaries' in advanced practice roles and which place the person in need of care at the centre of the service model. We also highlight the difficulties in differentiating between specialist, expanded and advanced roles and suggest further work is required to name, value and assess the contributions of such nursing roles.