Palliative Care Nurse

Palliative care nurses work with people who have life-limiting illnesses — cancer, heart failure, COPD, motor neurone disease, dementia — providing holistic care that addresses physical symptoms, psychological distress, social needs, and spiritual wellbeing. You carry out comprehensive holistic assessments, manage complex symptoms including pain, nausea, breathlessness, and agitation using palliative medications including strong opioids and anticipatory prescribing, and support people and their families through the process of dying. You help people to articulate and achieve their wishes about where they die and how they are cared for.

Palliative care nurses work in NHS hospices, NHS community palliative care teams, hospital palliative care specialist nurse teams (Macmillan Nurses and Clinical Nurse Specialists), and NHS community nursing. Macmillan Nurses are a specific type of CNS funded by Macmillan Cancer Support, working in NHS settings but with Macmillan-funded posts. Community palliative care nurses visit patients at home, coordinating with GPs, district nurses, social workers, and voluntary sector services to enable people to die at home if that is their wish. In hospice inpatient settings, you provide around-the-clock specialist nursing care during the last days or weeks of life. The role demands exceptional communication skill, the ability to have honest and compassionate conversations about dying, and sustained emotional resilience supported by regular clinical supervision.

End-of-life care is one of the most human and irreplaceable nursing specialities. The emotional and relational demands of accompanying people through dying cannot be automated, digitised, or replaced by lower-qualified workers. Demand is growing — the UK population is ageing, the number of people dying each year is projected to increase, and there is a widely recognised gap between where people wish to die (home) and where most deaths currently occur (hospital).

The NHS Long Term Plan and the Ambitions for Palliative and End of Life Care framework both commit to improving access to specialist palliative care. Hospice UK reports a persistent workforce gap in specialist palliative care nursing. Macmillan-funded CNS posts are protected by Macmillan Cancer Support's fundraising model, providing a degree of financial resilience independent of NHS budgets. NMC registration and specialist palliative care competencies create a valued professional standard.

Morning: arrive at the hospice inpatient unit, take handover from the night team. Complete assessment rounds for six patients — adjusting syringe driver settings for a patient with difficult pain, discussing breathlessness management with the palliative care consultant, and a sensitive conversation with a patient about their preferred place of death. Late morning: family meeting with the relatives of a patient approaching their final hours. Afternoon: community palliative care visit to a patient at home — assess symptom control, liaise with the GP about anticipatory medication, and provide reassurance to the family about what to expect in the coming days.