Holistic district nursing: caring for the terminally ill

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Abstract
Holistic care is the aspiration of the nursing profession yet in district nursing, it is becoming increasingly difficult to attain. Developments such as skill or grade mix and the employment of the social services carer, have carved up traditional district nursing into tasks that are allocated to a variety of nursing and related personnel, in a manner that is as cost-effective as possible. The traditional district nurse who was allowed the scope to attend to any patient need is an increasingly rare entity; some would argue rightly so. There is an exception to this, however, in the acute ‘holistic’ care of patients who are terminally ill. This paper discusses the changes to district nursing practice that have taken place in recent years and using supportive data from an ethnographic research study of district nursing work, explores why terminal care is so highly valued by the district nursing service.