Building Consensus

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Editorial
Consultant Editor Philip Larkin Editor Peter Black email ijpn@markallengroup.com Sales Manager Roger Allen email roger@markallengroup.com Editorial Make-Up Peter Constantine Production Manager Jon Redmayne Associate Publisher Liam Benison Publisher Matt Cianfarani Managing Director Mark Allen

Building consensus
ave you ever begun walking up a steep hill when it has been raining and misty, the route that you need to take is not clear, and the ground is wet and muddy underneath – you know that you need to reach the top but you are not sure how to get there. Then suddenly the mist clears, not only can you see the top where you are aiming for, but the path to reach it has become clear. This reflects the experience of the recent ANTEA Worldwide Palliative Care Conference 2008 in Rome. Eleven nurses from across the world had been invited to take part in a workshop in order to produce an international consensus document around palliative care nursing education with respect to educational goals, educational pathways and the skills and competencies required of palliative nurses. As we started the workshop, the way ahead seemed unclear – was it going to be possible to reach consensus regarding educational goals, pathways and competencies for palliative nurses and how would we achieve this in such a short time? Yet, as the workshop unfolded, it became clear that despite the differences in nurse education, in culture, and resources around the world, as nurses we had agreement about what it is palliative nurses should be able to do, and the need for education and training. Much work has been done in different countries with regard to competencies for palliative care, not just for nurses, but for the multidisciplinary team as a whole. While we believe in the multidisciplinary nature of palliative care and the need for multidisciplinary training, we were also clear that nurses have a unique and pivotal role to play in the provision of palliative care and that this needs to be recognized (Downing et al, 2006). There was a wealth of experience around the table and members were able to share the work that has been done in their region in this area. It is important not to ‘reinvent the wheel’ and, therefore, members shared their experiences in developing competencies. An important starting point was being clear of our definitions of palliative care and competencies so that we were all on the same page, and then addressing the different ‘levels’ of palliative nurses for whom we needed to develop competencies. Agreement was made to adopt the European Association of Palliative Care ‘Levels of Palliative Education’ (De Vlieger et al, 2004). In looking at the different competencies from around the world, it was clear that although they may be written to suit differing cultural contexts, the main competencies identified were similar across the board. Competencies from different regions were put side-by-side and then mapped in such a way that the group internationally agreed key domains. So, have we really reached a consensus on palliative nursing competencies across the world? This is just a start of the process, but an exciting one. A document is being compiled, which sets out the work done at the workshop, the levels of education, some suggested pathways and the competencies required by nurses at each level, along with the underpinning philosophies and principles for both palliative nursing and palliative nursing education. It is hoped that this document will be shared and there will be a process of building consensus from palliative care nurses across the world, beginning in Africa and then Europe. It is encouraging to see that while as nurses we work in a wide variety of different settings and cultures, have different pathways for nurse training, and have different resources available, we are committed globally to fundamental principles and JPN competencies for palliative care nursing. I●

Editorial Board
AUSTRALIA Donna Drew...
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