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McGuire HC, Costa J, Reville B. Career Impact of Palliative Care Fellowship Training for Nurse Practitioners. J Palliat Med 2024. [PMID: 38973555 DOI: 10.1089/jpm.2024.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
Background: Postgraduate fellowship training for nurse practitioners (NP) in palliative care can ameliorate workforce shortages; however, currently there are few NP fellowships and little evidence about outcomes, such as retention in hospice and palliative nursing, job satisfaction, or professional contributions. Objective: To describe the impact of palliative care fellowship training on the careers of NP alumni. Methods: A survey was electronically distributed to all NP alumni of an interprofessional palliative care fellowship since adult and pediatric nursing cohorts were added (2009-2022). Results: Most respondents still worked in hospice and/or palliative care; a majority of them engaged in professional activities beyond clinical work and reported high career satisfaction. Alumni endorsed multiple benefits of postgraduate fellowship except for post-fellowship compensation. Conclusions: NP palliative care fellowship alumni reported multiple career benefits including job satisfaction, professional accomplishment, and ongoing employment at their training institutions.
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Affiliation(s)
- Hilary Carroll McGuire
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jennifer Costa
- The Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Barbara Reville
- Harvard Medical School Center for Palliative Care, Boston, Massachusetts, USA
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Tejima Y, Mori S, Yoshino J, Yaguchi N, Imaizumi S. Insights into the experiences of nurse educators in end-of-life care: A qualitative study. Nurse Educ Pract 2024; 77:103980. [PMID: 38701685 DOI: 10.1016/j.nepr.2024.103980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/22/2024] [Accepted: 04/19/2024] [Indexed: 05/05/2024]
Abstract
AIM This study elucidated the experience of nurse educators instructing practicums for nursing students assigned to the care of end-of-life patients in fundamental nursing education. BACKGROUND With the growing population of older adults and increased mortality, nurses providing care for people at the end-of-life stage and their families (referred to as end-of-life nursing) will be increasingly important in Japanese healthcare settings. Acquiring knowledge and action-level methods can be insufficient for nursing students to approach the illness experiences of people at the end of their life and their families, increasing the importance of practicum in end-of-life nursing to enable learning from experience. This situation raised the need to study how nurse educators for nursing care for end-of-life patients experience the situation and what they practice as observed through the educator's standpoint to devise better teaching methods for end-of-life nursing practica. DESIGN Interpretative phenomenology was used. METHODS Semi-structured interviews were conducted with six nurse educators. Participants were interviewed about their experiences in teaching nursing students who care for people in the final stages of life. Data were analyzed using Benner's Interpretive phenomenological approach. RESULTS Nurse educators teaching students assigned to end-of-life patients experienced the [sudden appearance of patients themselves] and were involved in the nursing care for these end-of-life patients. They [seized the opportune "moments" for teaching] while [placing the value of practicum in end-of-life nursing in the "fragments" that students find] and then acknowledged that students were becoming aware of the core values of end-of-life nursing, even though they could not perform the techniques of care. Nurse educators also [recognized students as learners at the "borderline stage"] who are still distinct from nurses and valued students in their current state of development with hopes and expectations for further growth. CONCLUSIONS This study highlighted the importance of nurse educators leveraging their practical knowledge to provide direct guidance to nursing students in clinical settings. The educators approached patient care with intentionality, prioritizing the well-being of patients while engaging in co-existent care alongside the students. Simultaneously, they respected the nursing students in their transition to becoming nurses, harboring hopes and expectations for continued growth. Concurrently, they were curious about the patient and student. They sought to balance the interests of the two parties representing dissimilar temporality, thereby applying their intuitive embodied intelligence into practice. Such experiences were also interpreted from the temporality of nursing students in a transitional stage of becoming nurses.
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Affiliation(s)
- Yoshie Tejima
- Tokai University School of Medicine, Faculty of Nursing, Shimokasuya 143, Isehara, Kanagawa 259-1193, Japan.
| | - Sachiko Mori
- Tokai University School of Medicine, Faculty of Nursing, Shimokasuya 143, Isehara, Kanagawa 259-1193, Japan.
| | - Junko Yoshino
- Tokai University School of Medicine, Faculty of Nursing, Shimokasuya 143, Isehara, Kanagawa 259-1193, Japan.
| | - Naho Yaguchi
- Tokai University School of Medicine, Faculty of Nursing, Shimokasuya 143, Isehara, Kanagawa 259-1193, Japan.
| | - Satoko Imaizumi
- Tokai University School of Medicine, Faculty of Nursing, Shimokasuya 143, Isehara, Kanagawa 259-1193, Japan.
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Cormack CL, Smith W, Durham C, Lindell K, Reinbeck D. Advancing the Role of the Doctor of Nursing Practice in Palliative Care. J Hosp Palliat Nurs 2023; 25:309-313. [PMID: 37815252 DOI: 10.1097/njh.0000000000000984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Doctor of nursing practice-prepared nurses are well suited to provide high-quality palliative care to patients with serious illness and their caregivers. Their rigorous education and expertise prepare them for the complexity often associated with chronic disease and end of life. There are clear and strong recommendations from multiple national organizations supporting palliative care education for nurses and tools available for nurses to implement palliative care into practice. This article is from the perspective of the doctor of nursing practice nurse. It reviews the limited evidence on palliative care integration into the doctor of nursing practice role, the barriers to palliative care education and implementing palliative care into practice, and the potential roles that a doctor of nursing practice palliative care nurse may fill in health care.
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Osakwe ZT, Jacobowitz W, Horton JR, Klainberg M, Calixte R, Jacobs C, Hickey MT. Hospice and Palliative Care for Undergraduate Nursing Education: Results from a Delphi Study. Home Healthc Now 2023; 41:197-206. [PMID: 37417571 DOI: 10.1097/nhh.0000000000001178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
There is an urgent need to strengthen the nursing workforce through hospice and palliative care education to support patients living with serious illness. The aim of this study was to identify skills/topics in hospice and palliative care for undergraduate nursing education. We conducted a two-round online Delphi Survey of hospice and palliative care leaders and clinicians in New York State between June and August 2022. Participants were asked to list and rate the importance of clinical skills and topics in hospice and palliative care for undergraduate nursing education. Twenty-eight participants completed Round One and 21 participants completed Round Two. Topics ranked as extremely important were goals of care, patient/family education, communication skills, advance directives, medication management, pain management, and symptom management. Our findings highlight the importance of including the perspective of healthcare systems leaders and clinicians in discussions about training of future nurses to meet the needs of patients with serious illness and their families.
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Zehm A, Smith S, Schaefer KG, Jonas D, Bullock K, Edwards RL, Reville B, Jaramillo C, Webb AC, Rydberg J, Merel SE. Development of Objectives to Inform a National Standardized Primary Palliative Care Curriculum for Health Professions Students. J Palliat Med 2023; 26:406-410. [PMID: 36608317 DOI: 10.1089/jpm.2022.0396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Introduction: Despite recent educational advances, the need for a national standardized primary palliative care curriculum for health professions students remains evident. Methods: An interprofessional leadership team developed a set of core learning objectives built on previously published competencies. A survey was then sent to palliative care experts for feedback and consensus. Results: Twenty-eight of 31 objectives met a 75% consensus threshold, 2 were combined with others, and 12 were refined based on survey feedback. Discussion: With interprofessional input at all stages, we finalized a comprehensive list of 26 learning objectives for a primary palliative care curriculum targeting health professions students. These objectives will be widely available through an online course but can also be adopted for use by individual educators across health professions institutions. These objectives and related curriculum are critical to producing practice-ready clinicians who are prepared to care for the burgeoning population of seriously ill patients.
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Affiliation(s)
- April Zehm
- Division of Geriatric and Palliative Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sherilyn Smith
- Division of General Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA.,Aquifer, Inc., Lebanon, New Hampshire, USA
| | - Kristen G Schaefer
- Care Dimensions Hospice, Danvers, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Danielle Jonas
- Silver School of Social Work, New York University, New York, New York, USA
| | - Karen Bullock
- Boston College School of Social Work, Boston College, Chestnut Hill, Massachusetts, USA
| | - Rebecca L Edwards
- UAB School of Nursing, Department of Acute, Chronic, and Continuing Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Barbara Reville
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Psychosocial Oncology and Palliative Care, Harvard Medical School Center for Palliative Care, Boston, Massachusetts, USA
| | - Carolina Jaramillo
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy Carol Webb
- River of Grass Unitarian Universalist Congregation, Davie, Florida, USA
| | | | - Susan E Merel
- Division of General Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA.,Cambia Palliative Care Center of Excellence, Seattle, Washington, USA
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Jizba T, Iverson L, Hall A. Effects of the ELNEC Graduate Curriculum on Nurse Practitioner Students' Perceptions of Primary Palliative Care Competency. Nurse Educ 2023; 48:E64-E66. [PMID: 36066581 DOI: 10.1097/nne.0000000000001279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Theresa Jizba
- Assistant Professor (Dr Jizba) and Associate Professor (Dr Iverson), College of Nursing, and Biostatistics Faculty (Mr Hall), Creighton University, Omaha, Nebraska
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Updated palliative care competencies for entry-to-practice and advanced-level nursing students: New resources for nursing faculty. J Prof Nurs 2022; 42:250-261. [DOI: 10.1016/j.profnurs.2022.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/23/2022]
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Jeffers S, Lippe MP, Justice A, Ferry D, Borowik K, Connelly C. Nursing Student Perceptions of End-of-Life Communication Competence: A Qualitative Descriptive Study. J Hosp Palliat Nurs 2022; 24:199-205. [PMID: 35149655 DOI: 10.1097/njh.0000000000000849] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Effective communication skills are required when nurses care for patients and their families navigating life-limiting illness and the end of life. Educators have made great strides in integrating end-of-life content into prelicensure curricula. It is critical to evaluate nursing students' perceptions of their communication skills to empirically guide the development and implementation of future education interventions. The purpose of this qualitative descriptive study was to explore nursing students' perceptions of their verbal and nonverbal communication competence when providing end-of-life care. Students participated in an established high-fidelity simulation focused on difficult end-of-life conversations. Students explored their perceptions during postsimulation debriefing sessions. Colaizzi's method guided thematic analysis of the audio-recorded debriefings. One major theme emerged from the data: delivering bad news is difficult. Four subthemes further described this theme and its components: (1) reflecting on communication at end of life, (2) feeling uncomfortable, (3) calling for more exposure to end-of-life communication, and (4) fostering a supportive environment for patients and families. Results indicate that nursing students had anxiety and discomfort when engaging in end-of-life conversations. These findings support increased investments in additional training interventions to facilitate the development of student competence in end-of-life communication prior to entering the professional workforce.
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Calton BA, Saks N, Reid T, Shepard-Lopez N, Sumser B. An Interprofessional Primary Palliative Care Curriculum for Health Care Trainees and Practicing Clinicians. Palliat Med Rep 2022; 3:80-86. [PMID: 35733444 PMCID: PMC9153988 DOI: 10.1089/pmr.2021.0074] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Brook A. Calton
- Division of Palliative Medicine and Geriatrics, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Palliative Medicine, Department of Medicine, The University of California, San Francisco, San Francisco, California, USA
| | - Naomi Saks
- Division of Palliative Medicine, Department of Medicine, The University of California, San Francisco, San Francisco, California, USA
| | - Thomas Reid
- Division of Palliative Medicine, Department of Medicine, The University of California, San Francisco, San Francisco, California, USA
| | - Nancy Shepard-Lopez
- Division of Palliative Medicine, Department of Medicine, The University of California, San Francisco, San Francisco, California, USA
| | - Bridget Sumser
- Division of Palliative Medicine, Department of Medicine, The University of California, San Francisco, San Francisco, California, USA
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