An investigation into the role of a registered nurse during a patient admission to a hospice

Abstract

Abstract Title: An investigation of the role of the registered nurse during a patient’s admission to a hospice.

Background: Patient admission is an integral part of nursing work where nurses and patients can engage in the mutual exchange of information. Previous studies found a gap between nursing theory and clinical practice concerning the nursing admission process that required further exploration.

Aim: To investigate the role and contribution of the registered nurse in patient admission to a hospice.

Methods: A qualitative, multiple case study research design provided an opportunity for an in-depth exploration to gather detailed information from participants in a real-life context. Data collection occurred between June 2018 and January 2019 within a hospice in Scotland. Each case included observation of the admission, semi-structured interviews with those who participated in the admission interview, review of the patient record and field notes. Cases (n=5) were analysed using constant comparison, cross-case analysis, and thematic analysis.

Results: The nurses displayed a wide range of skills and behaviours during a patient’s admission to a hospice setting, with three behaviours featuring prominently:

1. The phrase ‘Getting to Know’ was used by nurses to describe how they developed their understanding of the patient and their situation.

2. ‘Assessing’ involved gathering information from multiple sources to help identify the patient needs and meet organisational care objectives.

3. The nurse was responsible for ‘Interpreting’ information obtained during the patient admission and summarising the data into written and verbal reports that accurately reflected the patient’s history.

Conclusion: New knowledge emerged to reveal that patient admission in a hospice setting is a shared and continuous process that extends beyond the initial discussion between the patient and the registered nurse. The nursing work involved is a sophisticated aspect of practice that requires a collaborative approach by the nursing team. The conceptual map helps to summarise the overarching proposition and the core constructs by reframing what we recognise as the registered nurse role in patient admission.