The National Cancer Institute (2021) defines palliative care as care that is meant to improve the quality of life of patients with a serious disease that can be provided with or without curative intent treatment. Palliative care addresses the whole person, not just their disease. With a goal of preventing or treating symptoms and side effects of the disease and its treatment, as well as any related psychological, social, and spiritual challenges, palliative care is appropriate for patients of all ages at all stages of disease.
This definition demonstrates palliative care as an interprofessional approach that includes care provided by physicians, nurses, social workers, psychologists, psychiatrists, pharmacists, spiritual care professionals, and respiratory, physical, and occupational therapists, as well as a variety of other disciplines necessary to prevent and manage symptoms. Providing patient-centered care and communication, aggressively managing symptoms, and coordinating care across settings to ensure that the patient’s goals of care are being met are important areas of focus for all healthcare professionals (National Consensus Project, 2018).
Palliative care and hospice care are often perceived as having the same goals. However, confusing the terms limits access to these important services. Palliative care is a philosophy of care and an organized, highly structured system for delivering care focused on providing relief from the symptoms and stress of a serious illness (Center to Advance Palliative Care, n.d.). Hospice is a form of palliative care that provides care to individuals who have a limited life expectancy (i.e., prognosis of six months or less) (National Consensus Project, 2018). Clinical research supports the value of palliative care in improving quality of life, including its potential to increase life expectancy (Vanbutsele et al, 2018). In its landmark report Dying in America, the Institute of Medicine (2014) noted that “palliative care is associated with a higher quality of life, including better understanding and communication, access to home care, emotional and spiritual support, well-being and dignity, care at time of death, and lighter symptom burden. Some evidence suggests that, on average, palliative care and hospice patients may live longer than similarly ill patients who do not receive such care” (p. 2).
Oncology nurses are critical participants in the delivery of palliative care. The Oncology Nursing Society’s (2022a, 2022b) positions on access to quality cancer care and certification of oncology nurses provide testimony to the role of oncology nurses in palliative care. Oncology nurse expertise and contributions are especially evident in their roles in oncology subspecialties of medical and radiation oncology. All oncology nursing certification examinations provided by the Oncology Nursing Certification Corporation (2022) include content on the physical and psychosocial aspects of palliative care in addition to addressing ethical and legal aspects.
Approved by the ONS Board of Directors November 2014. Reviewed January 2015, January 2016, March 2019, May 2022.
Center to Advance Palliative Care. (n.d.). About palliative care. https://www.capc.org/about/palliative-care
Institute of Medicine. (2014). Dying in America: Improving quality and honoring individual preferences near the end of life: Key findings and recommendations. https://nap.nationalacademies.org/catalog/18748/dying-in-america-improv…
National Cancer Institute. (2021). Palliative care in cancer. https://www.cancer.gov/about-cancer/advanced-cancer/care-choices/palliative-care-fact-sheet#:~:text=Palliative%20care%20is%20care%20meant,whole%2C%20not%20just%20their%20disease
National Consensus Project. (2018). Clinical practice guidelines for quality palliative care (4th ed.). https://www.nationalcoalitionhpc.org/wp-content/uploads/2018/10/NCHPC-N…
Oncology Nursing Certification Corporation. (2022). OCN® test content outline. https://www.oncc.org/files/2018OCNTestContentOutline.pdf
Oncology Nursing Society. (2022a). Access to quality cancer care [Position statement]. https://ons.org/advocacy-policy/positions/policy/access
Oncology Nursing Society. (2022b). Oncology certification for nurses [Position statement]. https://ons.org/advocacy-policy/positions/education/certification
Vanbutsele, G., Pardon, K., Van Belle, S., Surmont, V., De Laat, M., Colman, R., . . . Deliens, L. (2018). Effect of early and systematic integration of palliative care in patients with advanced cancer: A randomised controlled trial. Lancet Oncology, 19(3), 394-404. https://doi.org/10.1016/s1470-2045(18)30060-3