The Educational Needs of Professional Hospice Staff: An Ethnographic Inquiry

Abstract

Hospice care delivered by an interdisciplinary team of professional staff includes care of those individuals with a life-limiting illness and a prognosis of days to a few months. It serves a variety of individuals with a combination of multiple diseases and co-morbidities and provides support for their families. A skilled health workforce is needed to deliver quality hospice and palliative care services. Inconsistencies in hospice staff knowledge and provided education have been identified locally in Alberta and across Canada. In previous studies, hospice nurses have identified knowledge deficits in pain and symptom management, psychological and spiritual care, and communication with dying patients. This research, engaging a focused ethnographic methodology, occurred at a local 26-bed hospice. I immersed myself in the hospice culture and in the research process to understand ways that the culture of hospice care can shape the educational needs of professional hospice staff. Data consisted of semi-structured interviews of hospice staff key participants, observations of interdisciplinary hospice professionals during their daily work, examination of hospice cultural documents and artifacts, and the writing of field notes over three months. The study findings suggest that at the core of the hospice staff educational needs lies three primary themes: communication as an essential foundation of quality care; interdisciplinary collaboration is vital for team cohesiveness and lastly, the central care philosophy utilized by the hospice interdisciplinary team is person/resident and family-centered care. These findings offer suggestions for hospice education and further research. Relational care is foundational for this philosophy, with trusting relationships at the forefront of care.