Optimizing the Global Nursing Workforce to Ensure Universal Palliative Care Access and Alleviate Serious Health-Related Suffering Worldwide

William E Rosa; Amisha Parekh de Campos; Nauzley C Abedini; Tamryn F Gray; Huda Abu-Saad Huijer; Afsan Bhadelia; Juli McGowan Boit; Samuel Byiringiro; Nigel Crisp; Constance Dahlin; Patricia M Davidson; Sheila Davis; Liliana De Lima; Paul E Farmer; Betty R Ferrell; Vedaste Hategekimana; Viola Karanja; Felicia Marie Knaul; Julius D N Kpoeh; Joseph Lusaka; Samuel T Matula; Cory McMahon; Salimah H Meghani; Patricia J Moreland; Christian Ntizimira; Lukas Radbruch; M R Rajagopal; Julia Downing

doi:10.1016/j.jpainsymman.2021.07.014

Optimizing the Global Nursing Workforce to Ensure Universal Palliative Care Access and Alleviate Serious Health-Related Suffering Worldwide

J Pain Symptom Manage. 2022 Feb;63(2):e224-e236. doi: 10.1016/j.jpainsymman.2021.07.014. Epub 2021 Jul 29.

Authors

William E Rosa¹, Amisha Parekh de Campos², Nauzley C Abedini³, Tamryn F Gray⁴, Huda Abu-Saad Huijer⁵, Afsan Bhadelia⁶, Juli McGowan Boit⁷, Samuel Byiringiro⁸, Nigel Crisp⁹, Constance Dahlin¹⁰, Patricia M Davidson¹¹, Sheila Davis¹², Liliana De Lima¹³, Paul E Farmer¹⁴, Betty R Ferrell¹⁵, Vedaste Hategekimana¹⁶, Viola Karanja¹⁷, Felicia Marie Knaul¹⁸, Julius D N Kpoeh¹⁷, Joseph Lusaka¹⁷, Samuel T Matula¹⁹, Cory McMahon¹², Salimah H Meghani²⁰, Patricia J Moreland²¹, Christian Ntizimira²², Lukas Radbruch²³, M R Rajagopal²⁴, Julia Downing²⁵

Affiliations

¹ Department of Psychiatry and Behavioral Sciences (W.E.R.), Memorial Sloan Kettering Cancer Center, New York, USA. Electronic address: [email protected].
² University of Connecticut School of Nursing (A.P.D.C.), Storrs & Hospice Program, Middlesex Health, Connecticut, USA.
³ Division of Gerontology and Geriatric Medicine (N.C.A.), Department of Medicine, University of Washington, Seattle, Washington, USA.
⁴ Harvard Medical School (T.F.G.), Department of Psychosocial Oncology and Palliative Care, Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
⁵ Faculty of Health Sciences (H.A.S.H.), University of Balamand, Beirut, Lebanon.
⁶ Harvard T.H. Chan School of Public Health (A.B.), Boston, Massachusetts, USA.
⁷ Living Room International (J.M.B.), Eldoret, Kenya.
⁸ Johns Hopkins University School of Nursing (S.B.), Baltimore, Maryland, USA.
⁹ All-Party Parliamentary Group on Global Health (N.C.), House of Lords, Nursing Now Global Campaign, London, UK.
¹⁰ North Shore Medical Center (C.D.), Salem, Massachusetts, USA.
¹¹ The Vice-Chancellor's Unit (P.M.D.), University of Wollongong, New South Wales, Australia.
¹² Partners In Health (S.D., C.M.), Boston, Massachusetts, USA.
¹³ International Association for Hospice & Palliative Care (L.D.L.), Houston, Texas, USA.
¹⁴ Department of Global Health and Social Medicine (P.E.F.), Harvard Medical School, Boston, Massachusetts, USA.
¹⁵ Division of Nursing Research and Education (B.R.F.), Department of Population Sciences, City of Hope Medical Center, Duarte, California, USA.
¹⁶ Pain Free Hospital Initiative (V.H.), Rwanda Biomedical Center and Ministry of Health, Butaro, Rwanda.
¹⁷ Partners In Health Liberia (V.K., J.D.N.K, J.L.), Harper, Maryland County, Liberia.
¹⁸ University of Miami Institute for Advanced Study of the Americas (F.M.K.), Coral Gables, Florida, USA.
¹⁹ University of Botswana School of Nursing (S.T.M.), Gabarone, Botswana.
²⁰ University of Pennsylvania School of Nursing (S.H.M.), Philadelphia, Pennsylvania, USA.
²¹ Emory University Nell Hodgson Woodruff School of Nursing (P.J.M.), Atlanta, Georgia, USA.
²² African Center for Research on End-of-Life Care (C.N.), Kigali, Rwanda.
²³ Department of Palliative Medicine (L.R.), University Hospital Bonn, Bonn, Germany.
²⁴ Trivandrum Institute of Palliative Sciences (M.R.R.), Trivandrum, Kerala, India.
²⁵ International Children's Palliative Care Network (J.D.), Makerere University, Kampala, Uganda.

Abstract

Context: Palliative care access is fundamental to the highest attainable standard of health and a core component of universal health coverage. Forging universal palliative care access is insurmountable without strategically optimizing the nursing workforce and integrating palliative nursing into health systems at all levels. The COVID-19 pandemic has underscored both the critical need for accessible palliative care to alleviate serious health-related suffering and the key role of nurses to achieve this goal.

Objectives: 1) Summarize palliative nursing contributions to the expansion of palliative care access; 2) identify emerging nursing roles in alignment with global palliative care recommendations and policy agendas; 3) promote nursing leadership development to enhance universal access to palliative care services.

Methods: Empirical and policy literature review; best practice models; recommendations to optimize the palliative nursing workforce.

Results: Nurses working across settings provide a considerable untapped resource that can be leveraged to advance palliative care access and palliative care program development. Best practice models demonstrate promising approaches and outcomes related to education and training, policy and advocacy, and academic-practice partnerships.

Conclusion: An estimated 28 million nurses account for 59% of the international healthcare workforce and deliver up to 90% of primary health services. It has been well-documented that nurses are often the first or only healthcare provider available in many parts of the world. Strategic investments in international and interdisciplinary collaboration, as well as policy changes and the safe expansion of high-quality nursing care, can optimize the efforts of the global nursing workforce to mitigate serious health-related suffering.

Keywords: Palliative care; global health; global palliative care; nursing; palliative nursing; serious health-related suffering; universal health coverage.

Publication types

Research Support, N.I.H., Extramural
Review

MeSH terms

COVID-19*
Hospice and Palliative Care Nursing*
Humans
Palliative Care
Pandemics
SARS-CoV-2
Workforce

Abstract

Publication types

MeSH terms

Grants and funding