Despite a broad consensus and recommendations, numerous international reports or studies have shown the difficulties of implementing palliative care within healthcare services. The objective of this study was to understand the palliative approach of registered nurses in hospital medical and surgical care units and their use of mobile palliative care teams. Qualitative study using individual in depth semi-structured interviews and focus group of registered nurses. Data were analyzed using a semiopragmatic phenomenological analysis. Expert nurses of mobile palliative care team carried out this study. 20 registered nurses from three different hospitals in France agreed to participate. Nurses recognize their role as being witnesses to the patient’s experience through their constant presence. This is in line with their professional values and gives them an “alert role” that can anticipate a patient-centered palliative approach. The physician’s positioning on palliative care plays a key role in its implementation. The lack of recognition of the individual role of the nurse leads to a questioning of her/his professional values, causing inappropriate behavior and distress. According to nurses, “rethinking care within a team environment” allows for the anticipation of a patient-centered palliative approach. Mobile Palliative Care Team highlights the major role of physicians-nurses “balance” while providing personal and professional support. The Physician’s positioning and attitude toward palliative approach sets the tone for its early implementation and determines the behavior of different staff members within healthcare service. “Recognition at work”, specifically “recognition of the individual role of nurse” is an essential concept for understanding what causes the delay in the implementation of a palliative approach. Interprofessional training (physicians and nurses) could optimize sharing expertise. Registered nurses consider MPCT as a “facilitating intermediary” within the healthcare service improving communication. Restoring a balance in sharing care and decision between physicians and other caregivers lead care teams to an anticipated and patient-centered palliative approach according to guidelines.

中文翻译：

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现象学研究的护士在法国的医疗和外科护理部门中使用姑息治疗方法以及使用流动姑息治疗团队的经验

尽管有广泛的共识和建议，但许多国际报告或研究表明，在医疗保健服务中实施姑息治疗存在困难。这项研究的目的是了解医院医疗和外科护理部门中注册护士的姑息治疗方法以及他们对流动姑息治疗团队的使用情况。使用深度个人半结构化访谈和注册护士焦点小组进行定性研究。使用半实用现象学分析来分析数据。移动姑息治疗小组的专家护士进行了这项研究。来自法国三所不同医院的20名注册护士同意参加。护士通过不断地在场，认识到自己是患者经历的见证者。这符合他们的专业价值观，并赋予他们“预警角色”，可以预见以患者为中心的姑息治疗方法。医师对姑息治疗的定位在其实施中起着关键作用。缺乏对护士个人角色的认识导致对她/他的专业价值观的质疑，导致不当行为和困扰。根据护士的说法，“在团队环境中进行护理”可预见以患者为中心的姑息治疗方法。流动姑息治疗团队强调医生的主要作用-护理“平衡”，同时提供个人和专业支持。医师对姑息治疗方法的定位和态度为其早期实施奠定了基调，并确定了医疗服务中不同工作人员的行为。“工作中的认可”，特别是“对护士个人角色的认可”是理解导致姑息治疗方法实施延迟的根本概念。专业间培训（医生和护士）可以优化共享专业知识。注册护士将MPCT视为医疗服务中改善沟通的“中介机构”。恢复医师与其他护理人员之间共享护理和决策的平衡，可导致护理团队根据指南采取预期的以患者为中心的姑息治疗方法。注册护士将MPCT视为医疗服务中改善沟通的“中介机构”。恢复医师与其他护理人员之间共享护理和决策的平衡，可导致护理团队根据指南采取预期的以患者为中心的姑息治疗方法。注册护士认为MPCT是医疗服务中改善沟通的“便利中介”。恢复医师与其他护理人员之间共享护理和决策的平衡，可导致护理团队根据指南采取预期的以患者为中心的姑息治疗方法。