Developing expert palliative care
nursing through research and
Katherine Froggatt and Katie Booth
In this chapter, we present an account of expert nursing and its development through research and practice development in the context of palliative care. The meaning of expertness in the current climate of evidence-based practice is explored for individual practitioners in the context of organizational constraints and macro-policy initiatives. Our own expertise is based in the two national Macmillan Practice Development Units, funded by a leading UK cancer charity (Macmillan Cancer Relief). The units are involved in the production, dissemination and utilization of knowledge for and about practitioners working at an advanced level as clinical nurse specialists in cancer and palliative care.
We draw on different aspects of the programmes of work undertaken over the last 8 years in these two units to illuminate practical examples of ways in which expert nurses in palliative care have been supported. To do this, we will initially present an overview of the nature of expertness within health care in general, and within nursing in particular, and outline factors and pressures that currently shape the development of expert nursing. In conclusion, a number of challenges to developing expert palliative care nursing are presented.
Professional expertise is described by Higgs and Andresen (2001) as being grounded in three types of knowledge: research and theory, professional craft knowledge and personal experience. Expertness has many dimensions and, importantly, does not have absolute properties, as it is an individual attribute that is socially constructed (Higgs and Bithell 2001). Higgs and Bithell (2001) utilize two perspectives to understand professional expertise – historicism and the dimensions of expertise. In this way, they have