Another potential arena for conflict in
palliative care is the distinction between
the philosophy of 'democracy' with a flat
team structure, and the traditional medical
model, which places physicians at the
top of the healthcare hierarchy, ostensibly
as team leader, with allied-health professionals
playing a supporting role (Porter-
O'Grady and Wilson, 1998).
Willard and Luker (2005) report an
example that highlights these problems and
challenges. These authors explored how
specialist cancer nurses in the UK operate
across several settings, including palliative
care, following the implementation
of The NHS Cancer Plan (Department of
Health, 2000), which advocates supportive
care for patients and the adoption of interdisciplinary
teams. One of the major findings
of this study was that the dominant
agenda, usually the medically-driven treatment
agenda, impacted on what services
were provided and how they were provided,
what type of support was offered
and the role of the specialist cancer nurse.
Medical staff acted as gatekeepers, asserted
their power to block the nurses' access to
patients or relegated supportive care to a
subordinate role.
Democratic team structure
Another potential arena for conflict in
palliative care is the distinction between
the philosophy of 'democracy' with a flat
team structure, and the traditional medical
model, which places physicians at the
top of the healthcare hierarchy, ostensibly
as team leader, with allied-health professionals
playing a supporting role (Porter-
O'Grady and Wilson, 1998).
Willard and Luker (2005) report an
example that highlights these problems and
challenges. These authors explored how
specialist cancer nurses in the UK operate
across several settings, including palliative
care, following the implementation
of The NHS Cancer Plan (Department of
Health, 2000), which advocates supportive
care for patients and the adoption of interdisciplinary
teams. One of the major findings
of this study was that the dominant
agenda, usually the medically-driven treatment
agenda, impacted on what services
were provided and how they were provided,
what type of support was offered
and the role of the specialist cancer nurse.
Medical staff acted as gatekeepers, asserted
their power to block the nurses' access to
patients or relegated supportive care to a
subordinate role.
Democratic team structure
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