lop feelings of helplessness and insecurity because of her unrealistic expectations of herself. The complex role we play in management of the terminally ill sometimes may lead the nurse to think she should be all things to all people – the doctors ‘handmaiden’ the patients advocate, the families sounding board. Sometimes nurses can become over involved, infringing on the autonomy of the patient and the family (Scanlon, 1989) and must be aware of when to withdraw. At times when caring for a patient with uncontrollable physical or emotional pain the nurse may feel herself to be a failure. Add to this the likelihood of inadequate resources and staffing, staff conflict and role conflict and there is a pretty good recipe for stress. Abraham and Shandley (1992) list five main sources of work stress. These being: 1. Work overload, 2. Difficulties relating to other staff, 3. Difficulties involved in nursing critically ill patients 4.concerns over patient treatment and 5. Nursing patients who fail to improve. This again emphasises the fact that nurses specialising in palliative care are likely to suffer high levels of stress. CONCLUSIONTo help cope with these high demands and continue to maintain the delicate balance between what the patient wants and what the health professionals think the patient needs, nurses need to arm themselves with expert knowledge of symptom control, and be well aware of ethical issues related to palliative care. Nurses also need to maintain open active communication with their peers and other members of the Multidisciplinary Team. Employing some of the strategies we suggest for our patients to aid in relaxation such as Music and Laughter will also help in reducing levels of stress. But ultimately we must also realise that even if we do not influence a situation or supply an answer to all needs and if our patients do not maintain total autonomy, it is enough that we have been with them, supporting th...
