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Review: Using social worlds theory to explore influences on community nurses’ experiences of providing out of hours paediatric oncology palliative care

On behalf of the Secretary of State for Health in England, the Department of Health commissioned an independent review of palliative care services for children and young people which reported in 2007. The review acknowledged the need to standardise the provision of out of hours palliative care services for this patient group and their families (Craft and Killen, 2007). In the absence of national standards on the provision of out of hours palliative care services for children in England, the researchers who authored this paper were part of a research team that investigated the experiences of the community nurse, GP and allied health professionals (physiotherapist and occupational therapist) involved in the care of a child with cancer receiving palliative care at home. In this paper, they report on one aspect of this study, the experiences of paediatric nurses who provided out of hours home-care. They analysed the interview data following a grounded theory approach and used social worlds theory as a theoretical framework when interpreting their data. The authors reported that the nurses’ experiences were influenced by three main factors. The first was that the absence of national standards led nurses to provide care in services that were not formally recognised; the second that inter-professional working was regarded as less than optimal; and the third that nurses’ social worlds impacted on their experience. The authors described the nurses as working on a ‘voluntary’ basis when they were providing care in a service that was not formally recognised within the system. They suggest that a justification for working in this sub-optimal way is that it might enable the frontline staff to collect data that they could use to persuade decision-makers to formalise their service.