Oral Presentation Palliative Care Nurses Australia Conference 2020

Nursing People with Palliative and End-of-Life Care Needs: A Framework to Optimise Skill Capability of the Nursing Workforce (70423)

Claire Fraser 1 , Grace Buchanan 2
  1. University of Technology, Sydney, Sydney
  2. Cancer Council Western Australia, Perth


This professional development framework was developed as part of a global movement to quantify clinical skill expectations of nurses caring for patients and their families with palliative and end-of-life care needs. It aligns with the WA End-of-Life and Palliative Care Strategy 2018 – 2028, is modelled from the Competency Standards for Specialist Palliative Care Nursing Practice (Canning, Yates & Rosenberg, 2005) and mapped against the Palliative Care Australia National Palliative Care Standards (2018).



A combination of population ageing, increasing prevalence of chronic illnesses and people living longer with life-limiting illnesses has increased the need for a health workforce with palliative care capabilities. The profile and skills of the Australian healthcare workforce is shaped by these changing needs and demand for greater healthcare accessibility.

Whilst the Australian Government has invested heavily in increasing the palliative care capabilities of the existing nursing workforce, there is no system in place to measure this. This framework meets this requirement, applicable to nurses delivering a palliative approach through to specialist care across urban through to remote settings.



The domains of the Competency Standards for Specialist Palliative Care Nursing Practice have been linked to correlating clinical skills, guided by clinical experience, evidence and existing international competency frameworks; then mapped against the National Palliative Care Standards.

Benner’s model of skill acquisition was chosen to identify skill level (novice through to expert) as it best describes one’s ability at different stages. This tiered structure lends itself to the nursing hierarchy - allowing for different expectations for Enrolled Nurses through to Nurse Practitioners.


Implications for practice

Participants reflect on their practice and identify skill level, followed by meeting with a designated mentor - a senior clinician – where an in-depth discussion and examples are given to evaluate capability and areas for development.

This process clarifies skills required to provide effective end-of-life and palliative care, guides seamless integrated care from diagnosis through to bereavement, and helps management staff quantify skill capabilities and gaps in their workforce and tailor education accordingly.

This framework can be adapted to other specialties (i.e. paediatrics) and caring staff (i.e. residential facilities).

  1. Canning, D., Yates, P. & Rosenberg, J.P. (2005) Competency Standards for Specialist Palliative Care Nursing Practice. Brisbane: Queensland University of Technology. Palliative Care Australia. (2018). National Palliative Care Standards. 5th Edition. Accessed via http://palliativecare.org.au/wp-content/uploads/dlm_uploads/2018/02/PalliativeCare-National-Standards-2018_web-3.pdf#page=7 Benner, P. (1984). From novice to expert: excellence and power in clinical nursing practice. Menlo Park: Addison-Wesley. https://www.health.nsw.gov.au/nursing/projects/documents/novice-expert-benner.pdf WA Cancer and Palliative Care Network. (2018). WA End-of-Life and Palliative Care Strategy 2018–2028. Department of Health: Government of Western Australia.