Nausea and vomiting in terminally ill patients: towards a holistic approach

Nausea and vomiting are common and distressing symptoms of advanced cancer for which there are currently no systematic and rigorous assessment tools. The advent of extended nurse prescribing gives nurses the opportunity to address these symptoms but puts the onus on them to provide a clear rationale for prescribing decisions. A care study is used to illustrate aspects of holistic management of these symptoms. An assessment tool described by Twycross and Back (1998) is suggested as a method for the nurse prescriber to manage nausea and vomiting in a rigorous, holistic manner. Recommendations are made regarding the development of an holistic assessment model and a flow chart to guide decisions regarding the management of terminally ill patients with nausea and vomiting.