The nature of qualitative demands
In palliative care, there are subtle work pressures experienced
by community staff due to the nature of their job. This subtlety
makes these demands invisible and therefore more difficult
to ‘deal’ with when compared to a physical workload.
For example, when community nurses identify with dying
patients, it is likely that this will affect their psychological wellbeing.
Identifying with patients’ situations can easily trigger our
own personal and private losses, which we might have not yet
resolved. In extreme cases, such experiences can result in poor
quality of care from staff. Work situations may have in fact triggered
our own personal issues, and we now have concurrent
emotional demands while we are caring for dying patients.
Nurses may feel a sense of failure if the patient goes on to
die after they have cared for them—nurses may hold unrealistic
expectations about outcomes of palliative care and personal
achievement. Another struggle nurses my face is the expectation
of feeling emotionally attuned to every patient they care
for, and conversely, wanting to be appreciated by all patients
and work colleagues too. When this expectation is not met,
it may add subtle, invisible and unnecessary pressure for staff,
which might affect performance and confidence. With a lack
of confidence comes low self-esteem, and the downward spiral
continues. For example, a once calm and polite nurse suddenly
becomes abrupt and irritable with patients, which may lead
to errors of judgement and decision-making (Rantanen et al,
2016). In a study by Nyatanga (2011), a few more qualitative