A qualitative interview study published in BMC Palliative Care explores how nurses experience expanded responsibilities and independent decision-making within specialized outpatient palliative care. As healthcare systems worldwide focus on expanding nursing practice to meet increasing demand, the study aims to clarify how nurses perceive these shifts in their professional roles when delivering care in complex situations.
The study utilized a qualitative design, specifically grounded theory methodology according to Strauss and Corbin, to develop an explanatory model of the phenomenon. Between June and August 2025, the researchers conducted individual semi-structured interviews with 20 nurses who had current or previous work experience in specialized outpatient palliative care.
The core finding of the research identifies a phenomenon described as “responsibility borne in relationship-based autonomy.” This concept suggests that nurses do not operate in isolation but rather exercise their independence while remaining deeply embedded in trusting interprofessional relationships and supportive team structures.
Several intervening conditions were identified as critical to this experience. These include attitudes toward autonomy in nursing practice, the self-confidence of the nurses, and the trust extended by colleagues, physicians, patients, and families.
Nurses employed specific strategies to manage these responsibilities. They engaged in interprofessional collaboration to promote multi-perspective dialogue, ensuring that decisions were informed by a variety of professional viewpoints. Additionally, they relied on their specialized knowledge and extensive work experience to navigate complex care scenarios.
The consequences of this practice model were multifaceted. Nurses reported experiencing their work as meaningful and perceived improvements in the overall quality of care provided to patients. However, the study also noted a significant ambivalence between professional empowerment and stressors.
Contextual factors played a vital role in shaping these experiences. Managing complex care situations in patients’ homes required a holistic understanding of the patients’ lives and circumstances. The strong commitment of nurses to patients and their families further influenced how they navigated their expanded roles.
The study concludes that professional autonomy in specialized outpatient palliative care emerges within a relational and collaborative context. Confidence in one’s professional competence, interprofessional recognition, trust, and supportive organizational structures are identified as essential for feeling safe when exercising professional judgment.
Subject of Research: Qualitative study on nurses' experiences of expanded responsibilities and independent decision-making in specialized outpatient palliative care.
Article Title: Nurses’ experiences of expanded responsibilities, independent decision-making and action in specialized outpatient palliative care: a qualitative interview study
Article References: Regelmann, E.-M., Owusu Boakye, S., Pöhner, J., & Stanze, H. (2026). Nurses’ experiences of expanded responsibilities, independent decision-making and action in specialized outpatient palliative care: a qualitative interview study. BMC Palliative Care, 25(1), Article 330. https://doi.org/10.1186/s12904-026-02399-0
Image Credits: AI Generated
DOI: 10.1186/s12904-026-02399-0
Keywords: palliative care, nursing practice, professional autonomy, qualitative research, outpatient care, interprofessional collaboration, healthcare systems, clinical decision-making, Nurses, experiences, expanded, responsibilities
News Source: Ophelia Keating. (November 10, 2026). Nurses in Palliative Care Find Autonomy in Team Trust. Scienmag.
