Nurses learn to confront death – and to help patients do the same

January 11, 2013 | by Hiu Chung So

For terminally ill patients and their loved ones, preparing for those final moments and to die with peace of mind is crucial. For them, "death with dignity" is no longer a vague concept. But the health-care system has traditionally been focused on delaying, if not actually ignoring, the reality that eventually must confront us all.

Now, however, health-care workers – specifically nurses – are learning how to guide patients and their caregivers through the last phase of life. They're using training developed in no small part at City of Hope.

Betty Ferrell Betty Ferrell, Ph.D., R.N., saw a need for better end-of-life care and developed a curriculum to help nurses and other health-care professionals provide it.

This evolution in health care was highlighted this week in a cover story by The New York Times.  The article focused on work by the End-of-Life Nursing Education Consortium (ELNEC), a project led by the American Association of Colleges of Nursing and by City of Hope. The project provides nurses, educators and other health-care professionals with training that specifically addresses patients' end-of-life needs.

As the story notes:  "Spending time with the dying is not fundamental to nurse training, partly because there are not enough clinical settings to provide the experience. [The consortium] has provided training in palliative care to some 15,000 nurses and nursing instructors around the nation since 2000, focusing not just on pain management but also on how to help terminally ill patients and their families prepare for death."

Courses in the curriculum  include pain and symptom management, grief and bereavement,  legal and ethical issues, spiritual care and cultural considerations.

According to ELNEC project director Pamela Malloy, nursing schools often neglect this type of training.

"We live in a death-denying society, and that includes nursing," Malloy told The New York Times.

Betty Ferrell, Ph.D., R.N., professor in City of Hope's Division of Nursing Research and Education, led the development of the ELNEC curriculum in order to turn the tide in this knowledge gap.

"As the primary professionals at the bedside across settings, nurses play a vital role in care for the seriously ill and dying," said Ferrell, principal investigator of the project. "But nurses can't practice what they don't know — thus education for nurses is vital, and there has been important progress made in the past decade."

Since its inception in 2000, ELNEC has trained nurses in all 50 states and in 74 countries. Additionally, because ELNEC "trains the trainers," Ferrell said, the graduates can take those lessons to their respective workplaces, furthering the awareness, knowledge and practice of end-of-life care in hospitals, clinics, nursing homes and hospices.

"By empowering nurses and other health-care professionals with these skills, seriously ill patients and their families can expect and receive excellent care at the end of life," Ferrell said.

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