“It’s Different in the Home …” The Contextual Challenges and Rewards of Providing Palliative Nursing Care in Community Settings

Abstract

Using thematic analysis, the purpose of this article was to report an in-depth analysis of the context of the significant work-life experiences for RNs who provide palliative care in community (ie, home-based) settings. Twenty-seven open-ended interviews were conducted with 14 palliative care nurse participants who were practicing in community settings in a Western Canadian province. Data also included a personal journaling exercise completed by nine of the participants. Data were transcribed verbatim, and a thematic analysis was conducted using constant comparative methods. The findings of this study reflect the unique geographical, physical, and social realities of palliative care nursing in community settings. The contextual challenges and rewards of working in community palliative nursing practice were reflected in four main themes: (1) who I am, (2) resigning myself to the system, (3) feeling valued and respected, and (4) managing grief and loss. Although the participants were dealing with numerous challenges and forms of occupational stress, they were strengthened and motivated by their positive work-life experiences. Continued research in this area may lead to interventions that can be used to support, sustain, and recognize the knowledge and expertise of nurses who provide palliative and end-of-life care in community settings.