Advanced Practice Nurses and Palliative Care Roles
This paper examines the development of palliative care from its origins in the 1960s through its current global expansion, tracing key milestones such as the founding of St. Christopher's Hospice by Cicely Saunders. It reviews evolving definitions of palliative care from the WHO, NCI, and ACS, and discusses persistent inequities in access — particularly for non-cancer patients and those in low-to-middle-income countries. The paper also addresses the importance of timely patient referrals and the multidisciplinary approach palliative care requires. Finally, it highlights the growing and formally recognized role of Advanced Practice Nurses (APNs) in delivering holistic, cost-effective palliative care across underserved populations.
- Introduction to Palliative Care: Origins and history of palliative care specialty
- Global Growth and Access Challenges: Expansion of palliative care and persistent inequities
- Defining Palliative Care: WHO, NCI, and ACS Perspectives: Comparing institutional definitions of palliative care
- Patient Referral for Palliative Care: Importance and timing of palliative care referrals
- Role of APNs in Palliative Care: APNs' expanding contributions to palliative practice
- Conclusion: Future needs and integration of palliative care
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What makes this paper effective
- Grounds the topic in historical context, tracing palliative care's origins to the 1960s and the founding of St. Christopher's Hospice, giving readers a clear developmental arc.
- Draws on multiple authoritative definitions (WHO, NCI, ACS) to show the evolving conceptual scope of palliative care, strengthening the paper's analytical credibility.
- Effectively uses cited empirical data — such as the 138% growth in palliative care teams and the statistic that only 10% of global need is met — to ground abstract arguments in concrete evidence.
- Connects macro-level policy concerns (global inequity, political support) to the micro-level practice role of APNs, creating a coherent argument for professional engagement.
Key academic technique demonstrated
The paper demonstrates the technique of multi-source synthesis: rather than relying on a single authority, it weaves together institutional definitions, epidemiological statistics, and clinical observations from multiple cited works to build a layered, evidence-based argument. This is especially evident in the section comparing WHO, NCI, and ACS definitions, where the author moves from description to comparative analysis.
Structure breakdown
The paper opens with a historical introduction establishing palliative care's origins and early context. It then widens to address global growth statistics and persistent access inequities before narrowing again to definitional frameworks. The middle sections cover timely patient referral and its impact on quality of life. The paper closes with a focused argument for the expanding role of APNs, culminating in an appeal for integration of palliative care into broader healthcare and educational systems.
Introduction to Palliative Care
Palliative care is a relatively new specialty that has evolved steadily over the past few decades. Its goal is to provide advanced cancer patients with end-of-life care. Its rise stemmed from the public's growing dissatisfaction and concern with how dying patients were being treated in the 1960s and 1970s (Cole, Carlin & Carlson, 2015). At the time, oncologists were primarily concerned with curative interventions and did not give the necessary attention to end-of-life care. According to studies conducted during that period, medical care given to the terminally ill was suboptimal or, in some cases, essentially nonexistent.
Cicely Saunders, widely regarded as the founder of modern palliative care, reported having the same experience firsthand. She established St. Christopher's Hospice in the United Kingdom — the first modern hospice facility. Its founding was a defining moment that would shape palliative care around the world (alMahrezi & AlMandhari, 2016).
Global Growth and Access Challenges
There has been tremendous growth in palliative medicine with respect to needs, concepts, and recognition. Discussions about end-of-life and palliative care have been highly productive since the dawn of the millennium (Cole, Carlin & Carlson, 2015). Palliative care teams in healthcare settings have grown by 138% in the new millennium. The specialty has expanded significantly, and providers have increasingly embraced it as better-trained professionals and apprentices emerge to deliver palliative services.
Nonetheless, access to palliative care remains limited due to inequity in the distribution of care, with most facilities concentrated in wealthier areas. Those not suffering from cancer still have restricted access to palliative services. Globally, over 20 million people — 6% of whom are children, and 78% of whom live in low- to middle-income nations — need palliative care. Yet only 10% of that need is currently being met (alMahrezi & AlMandhari, 2016).
References
alMahrezi, A., & AlMandhari, Z. (2016). Palliative care: Time for action. Oman Medical Journal, 161–163.
Bhatnagar, S., & Gupta, M. (2015). Future of palliative medicine. Indian Journal of Palliative Care, 95–104.
Bruera, E., & Hui, D. (2010). Integrating supportive and palliative care in the trajectory of cancer: Establishing goals and models of care. Journal of Clinical Oncology, 28, 4013–4017.
Cole, T. R., Carlin, N. S., & Carson, R. A. (2015). Medical humanities: An introduction (1st ed.). Cambridge University Press.
Devi, P. S. (2011). A timely referral to palliative care team improves quality of life. Indian Journal of Palliative Care, S14–S16.
George, T. (2016). Role of the advanced practice nurse in palliative care. International Journal of Palliative Nursing.
Kuebler, K. K. (n.d.). The palliative care advanced practice nurse. Journal of Palliative Medicine, 707–714.
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