Laura Lunardi
Royal Adelaide Hospital, Australia
Title: Strategies, barriers and significance for renal supportive care: role of the nurse practitioner
Biography
Biography: Laura Lunardi
Abstract
A Renal Supportive Care Nurse Practitioner (NP) role was created in Adelaide, Australia in October 2014. The integration of the role has brought with it service-wide changes in clinical practice and culture within our unit. There is now a closer integration with the local palliative care team, a greater emphasis on quality of life and active management of symptoms with more informed choices and care planning now available. This paper aims to describe the role of the NP in Renal Supportive Care (RSC) as it has emerged in South Australia. It also identifies barriers and strategies used by the RSC NP to enhance appropriate decision-making and conservative care for patients facing End Stage Kidney Disease (ESKD). Differing models of RSC are emerging across Australasia. The strengths and weaknesses of the South Australia approach will be elucidated as will the challenges facing RSC in the future. The transformative effects of the role will be explored, and key enablers for success identified. The full integration of a meaningful supportive care pathway for patients facing ESKD involves more than fine words and good intentions. It requires significant leadership, considerable resources and service-wide cultural, and clinical practice changes. The emergence of RSC is the key to a comprehensive renal service, demonstrating maturation of our shared aspirations in providing: interdisciplinary care that fine-tunes the balance between organ-based and whole-of-person care, engagement in full and open decision-making support with people facing renal treatment options and recognising and respecting the natural endpoint of an end-stage disease process.