Heart failure nurses' experiences of providing palliative care for people with heart failure

BACKGROUND: Heart failure is a chronic, progressive condition with a high symptom burden and a high mortality rate. AIM: To explore the experiences of heart failure nurses in delivering palliative care to patients with heart failure. METHODS: A qualitative study using semi-structured interviews. RESULTS: Three main themes emerged: the heart failure nurse's role in advance care planning; challenges and barriers to the provision of palliative care; and the positive impact of education and collaboration. Participants reflected on the shift in mindset with palliative care originally seen as outside their scope of practice to a care pathway and now being integral to their role. This was underpinned by the provision of specific training, sharing of practice and growing exposure to clinical practice across settings which facilitated this process. CONCLUSIONS: Heart failure nurses are in a unique position to provide palliative care for their patients, but they highlight that current palliative care provision fails to meet the specific needs of patients with heart failure at a systems level. Palliative care services are inconsistent across and within systems and professions which is attributed to both a lack of resources and a lack of understanding. A collaborative model which integrates palliative care, cardiology and primary care teams is required to lead to more holistic patient care. Further research is needed to ascertain the most effective models to integrate palliative care into the management of people with heart failure and assess patient and caregiver perspectives. IMPLICATIONS FOR PRACTICE: Palliative care should be integrated into routine heart failure management through clear referral pathways and multidisciplinary collaboration. Targeted education and training can support heart failure nurses in advance care planning, symptom management and end-of-life care, enabling earlier and more person-centred support for patients and caregivers.