Becoming competent in palliative care as perceived by nurses attending a Master programme : A qualitative study

This study analysed the perceived process of developing competence in a group of nurses attending a University Master programme in Palliative Care (PC). To evaluate and monitor PC competences, validated questionnaires are available in the literature. Nevertheless, nursing competence in PC is not always evident and measurable. Qualitative instruments as interviews, focus groups could be useful to explore that aspect of nurses’ expertise and to better evaluate the development of competence in PC during and after training experiences Since we focused on a process, we opted to follow the Grounded Theory method. Data were collected through three focus groups, carried out at the beginning, in the middle and at the end of the training. All the nurses participating in the programme were involved. The development of nurses’ competence in PC turned out to be characterised by: 1) transforming clients’ representation from a fixed and uniformed image of the patient to a multi-faceted idea of him/her; 2) transforming the idea of the family from an obstacle to a system integrated with patients; 3) proceeding from an idealized representation of the team to its perception as a real working group; 4) experiencing the accompanying to death as a feasible team work and no more as a solitary endeavour; 5) shifting from a focus just on relational needs to competence in a global patient’s management. Nurses who apply for post-graduate PC training appear to have high predisposition towards considering communicative/relational competences as crucial in that field. Nevertheless, they should be oriented to critically reflect on these core competences to transform their often idealised, and therefore self-protective, image of patients.