Bridging Neurosurgery and Palliative Care: The Unique Role of the Dual-Certified Nurse Practitioner

Serious neurological illness and injury are often followed by an unpredictable trajectory of hospitalization and recovery beyond the initial period of stabilization. Patients can experience serious cognitive and functional deficits with looming uncertainty about recovery. Advances in neurosurgical and neurocritical care have increased opportunities for improved outcomes and mortality. Patients with stroke, traumatic brain and spinal cord injury, brain cancer, and progressive neurodegenerative disorders may survive with significant morbidity and ongoing care needs. Neuropalliative care provides a framework to address these concerns through communication, symptom management, and goals of care discussions to ensure alignment of treatment options with patient-centered goals. Despite increasing recognition of these palliative care principles, there is limited integration within neurosurgical practice. Thus, an acute care nurse practitioner (NP) in a neurosurgical subspecialty with additional board certification and expertise in hospice and palliative care plays an important role at the intersection of these disciplines. This article explores the contributions of the dual-certified NP in a neurosurgery subspecialty incorporating palliative care principles into a patient- and caregiver-centric approach for managing serious neurological illness and injury.