Time expenditure in patient-related care provided by specialist palliative care nurses in a community hospice service

Although the importance of specialist palliative care in home care programmes for terminally ill patients is well known, German community hospice services did not begin to employ nurses who had specialized in palliative care until the early 1990s. The general tasks of these nurses are sufficiently well defined, but no comprehensive data of their daily workload are available in Germany to date. The present article examines time expenditure in direct patient-related care at the community-based hospice service in Mainz, Germany, by analysing time registration sheets concerning 351 patients who received care from January 2000 until December 2002. Fifty-five per cent of care time spent on each individual patient was in direct contact with that patient and/or his or her relatives, 20% of the time was spent on networking and other related tasks, 17% on travelling and 8% on bereavement counselling. Activities in direct patient contact were allotted to pain and symptom control (36.4%) and psychosocial support of the patient (32.4%) or his or her relatives (27.1%), whereas nursing issues played a minor role (4%).