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Cross LA, Lee B, Adams K. Mapping Competencies and Recommendations for Educating Nursing Students (CARES): Reviewing Palliative Care in a Baccalaureate Nursing Program. J Hosp Palliat Nurs 2024; 26:282-288. [PMID: 39088799 DOI: 10.1097/njh.0000000000001055] [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: 08/03/2024]
Abstract
The Competencies and Recommendations for Educating undergraduate Nursing Students (CARES) was originally designed for nursing students' palliative and end-of-life care education. The competencies were later revised to align with the 2021 American Association of Colleges of Nursing Essentials core competencies for baccalaureate nursing education. This project aimed to (1) review the courses in an accelerated baccalaureate nursing program for alignment with CARES, (2) determine any gaps, and (3) make program recommendations. The CARES competencies and Essentials were mapped according to the nursing program's 12 core curriculum courses and evaluated. Three CARES competencies were not met, and 12 were partially met. Areas of improvement were identified across the curriculum. Results of the mapping included palliative concepts needing earlier program introduction, reflective journaling was recommended for clinical practice courses, and incorporation of palliative care simulations was proposed to bridge the gaps.
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Bove DG, Simonsen SS, Herling SF, Timm H. Emergency nurses' experiences of caring for brought-in-dead persons and their relatives-a qualitative study. J Adv Nurs 2024. [PMID: 39104304 DOI: 10.1111/jan.16371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/10/2024] [Accepted: 07/22/2024] [Indexed: 08/07/2024]
Abstract
AIM To explore how emergency nurses experienced caring for brought-in-dead persons and their relatives, and what hindered or facilitated this care in an emergency setting. DESIGN A qualitative study using Interpretive Description. METHODS Data were collected as individual interviews with 13 nurses at seven Danish emergency departments from February to June 2023. FINDINGS Our analysis revealed the overarching theme 'Navigating the complexities of providing holistic care in a constrained environment', covering five sub-themes: (1) An important yet not recognized nursing task; (2) Pending care needs of the living and the dead; (3) No physical or mental room for the brought-in-dead persons; (4) Utilizing personal experiences in the absence of formal education and training and (5) Navigating professionalism and empathy. CONCLUSION Emergency departments posed unique challenges in providing care to brought-in-dead persons and their relatives. IMPLICATIONS FOR THE PROFESSION The unrecognized nature of caring for brought-in-dead persons and their relatives suggests a universal undervaluation of this care in emergency departments. IMPACT Care for brought-in-dead persons and their relatives is neither recognized nor evidence-based. This study initiates a discussion of the circumstances for delivering care for persons brought-in-dead and has an impact on nurses and nursing leaders employed in emergency departments. REPORTING METHOD The Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC CONTRIBUTION None.
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Affiliation(s)
- D G Bove
- Centre for Nursing, University College Absalon, Roskilde, Denmark
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | - S S Simonsen
- Centre for Nursing, University College Absalon, Roskilde, Denmark
| | - S F Herling
- The Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Copenhhagen, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - H Timm
- The University Hospitals Centre for Health Research, Rigshospitalet, Copenhagen, Denmark
- National Institute of Public Health, University of Southern, Odense, Denmark
- Faculty of Health Sciences, University of the Faroe Islands, Torshavn, Faroe Islands
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Carrió-Fito J, Terrón-Pérez M. Knowledge and training among nursing students regarding the conspiracy of silence in palliative care: A participatory action research. Nurse Educ Pract 2024; 79:104086. [PMID: 39116669 DOI: 10.1016/j.nepr.2024.104086] [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: 01/25/2024] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
AIM To develop and implement specific training based on the knowledge and management of conspiracy of silence among nursing students. BACKGROUND Conspiracy of silence refers to the concealment of information from a patient on the family's request, under the influence of a paternalistic culture that seeks to protect the patient. DESIGN Participatory action research. METHODS Was conducted in the following stages: reconnaissance (focus groups); planning, action and observation (theoretical sessions); and reflection (analysis of care plans). The focus group consisted of six fourth year and eight second-year students. The intervention was conducted with 42 s-year students and a total of 93 s-year students participated in the resolution of the clinical case. The study was conducted between October 2022 and June 2023 at the Faculty of Nursing, University of Valencia. For data analysis, the process described by Carrillo et al. (2011) was followed, involving coding and the creation of categories and subcategories. RESULTS The focus group deficiencies were detected in the students' learning of palliative care competence, breaking bad news and the conspiracy of silence (reconnaissance stage). Therefore, an intervention was conducted to reinforce these knowledge areas, specifically addressing the conspiracy of silence (planning, action and observation stages). The resolution of the case showed how students with training approached the situation more comprehensively, including the family and proposed activities that were consistent with managing the situation (reflection stage). CONCLUSIONS An active feedback process was successfully established, where the students' feedback helped create specific training on oncological palliative care and provided the students with tools to manage the conspiracy of silence. The results underscore the importance of providing students with training in palliative care and managing conspiracy of silence, through therapeutic communication training, active training or enhancing emotional intelligence. This training is essential for cultivating the attitudes and skills required to deliver high-quality palliative care.
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Affiliation(s)
- Julia Carrió-Fito
- Department of Nursing, University of Valencia, Menéndez Pelayo, 19, Valencia 46010, Spain.
| | - Marta Terrón-Pérez
- Department of Nursing, University of Valencia, Menéndez Pelayo, 19, Valencia 46010, Spain.
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Byrd E, McMath A, Ware J, Jacobs R, Weaver K. End-of-Life Education in a Prelicensure Nursing Program. J Hosp Palliat Nurs 2024:00129191-990000000-00145. [PMID: 39078142 DOI: 10.1097/njh.0000000000001057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
The demand for palliative and end-of-life nursing is increasing with the aging US population. The American Association of Colleges of Nursing published recommendations for incorporating palliative and end-of-life care across nursing curriculum to prepare the future workforce. However, recommendations regarding teaching end-of-life content are limited. This project aimed to integrate and evaluate the outcomes of end-of-life education introduced in a prelicensure nursing program. Using a documentary created by the American Nurses Foundation, students had the opportunity to discuss common themes in end-of-life care, practice morgue care in the simulation laboratory, and practice reflective journaling. The students' preevaluations and postevaluations indicated that the educational program significantly increased their confidence in providing end-of-life care and support to patients and families, demonstrating the importance of end-of-life curricula in nursing school.
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Salmani N, Keshmiri F, Bagheri I. The effect of combined training (theoretical-practical) of palliative care on perceived self-efficacy of nursing students. PLoS One 2024; 19:e0302938. [PMID: 38990859 PMCID: PMC11238957 DOI: 10.1371/journal.pone.0302938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 04/15/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Nurses and researchers emphasize the importance of adding educational content of palliative care to nursing curricula in Iran as a means to improve the quality of care at the end of life and self-efficacy is considered as an important determinant in palliative care nursing. However, undergraduate nursing students are not sufficiently trained to achieve the qualifications required in palliative care. The aim of this study was to determine the effect of combined training (theoretical-practical) of palliative care on the perceived self-efficacy of nursing students. METHODS This is a semi-experimental study with a pretest-posttest design. Sampling was nonrandomized with convenience method and included 23 seventh-semester students. The intervention consisted of palliative care training for ten theoretical sessions and three practical sessions. Data were collected using demographic and the perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed in the statistical SPSS 23 software using descriptive and analytical statistics. RESULTS The mean age of the samples was 22.78 (SD1.17). Most of the participants were male (56.5%) and single(91.3%). The findings showed that, perceived self-efficacy, psycho-social support and symptom management improved significantly after the intervention (p<0.05). CONCLUSION Palliative care training can increase the nursing students perceived self-efficacy. Since nursing students are the future nurses of the care system, therefore, managers and planners can take a step towards improving the quality of nursing care by using palliative care training programs. Since nursing students will be future nurses in health care system, therefore, managers and planners can take steps to improve the quality of nursing care by using palliative care education programs.
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Affiliation(s)
- Naiire Salmani
- Research Center for Nursing and Midwifery Care, Non-Communicable Diseases Institute, Nursing Faculty, Meybod Nursing School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Keshmiri
- Educational Development Center, Medical Education Department, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Imaneh Bagheri
- Research Center for Nursing and Midwifery Care, Department of Nursing, Non-Communicable Diseases Institute, Nursing Faculty, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Ernsth Bravell M, Johansson L. Need and importance of reflections of dignity at the end of life for nursing students. Evid Based Nurs 2024:ebnurs-2024-103972. [PMID: 38866429 DOI: 10.1136/ebnurs-2024-103972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2024] [Indexed: 06/14/2024]
Affiliation(s)
| | - Linda Johansson
- Institute of Gerontology, Jonkoping University, Jonkoping, Sweden
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Schroeder J, Pesut B, Olsen L, Oelke ND, Sharp H. Developing a survey to measure nursing students' knowledge, attitudes and beliefs, influences, and willingness to be involved in Medical Assistance in Dying (MAiD): a mixed method modified e-Delphi study. BMC Nurs 2024; 23:326. [PMID: 38745233 PMCID: PMC11092000 DOI: 10.1186/s12912-024-01984-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/28/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Medical Assistance in Dying (MAiD) was legalized in Canada in 2016. Canada's legislation is the first to permit Nurse Practitioners (NP) to serve as independent MAiD assessors and providers. Registered Nurses' (RN) also have important roles in MAiD that include MAiD care coordination; client and family teaching and support, MAiD procedural quality; healthcare provider and public education; and bereavement care for family. Nurses have a right under the law to conscientious objection to participating in MAiD. Therefore, it is essential to prepare nurses in their entry-level education for the practice implications and moral complexities inherent in this practice. Knowing what nursing students think about MAiD is a critical first step. Therefore, the purpose of this study was to develop a survey to measure nursing students' knowledge, attitudes and beliefs, influences, and willingness to be involved in MAiD in the Canadian context. METHODS The design was a mixed-method, modified e-Delphi method that entailed item generation from the literature, item refinement through a 2 round survey of an expert faculty panel, and item validation through a cognitive focus group interview with nursing students. The settings were a University located in an urban area and a College located in a rural area in Western Canada. RESULTS During phase 1, a 56-item survey was developed from existing literature that included demographic items and items designed to measure experience with death and dying (including MAiD), education and preparation, attitudes and beliefs, influences on those beliefs, and anticipated future involvement. During phase 2, an expert faculty panel reviewed, modified, and prioritized the items yielding 51 items. During phase 3, a sample of nursing students further evaluated and modified the language in the survey to aid readability and comprehension. The final survey consists of 45 items including 4 case studies. DISCUSSION Systematic evaluation of knowledge-to-date coupled with stakeholder perspectives supports robust survey design. This study yielded a survey to assess nursing students' attitudes toward MAiD in a Canadian context. CONCLUSION The survey is appropriate for use in education and research to measure knowledge and attitudes about MAiD among nurse trainees and can be a helpful step in preparing nursing students for entry-level practice.
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Affiliation(s)
- Jocelyn Schroeder
- School of Health and Human Services, Selkirk College, Castlegar, BC, Canada
| | - Barbara Pesut
- School of Health and Human Services, Selkirk College, Castlegar, BC, Canada.
- School of Nursing, University of British Columbia Okanagan, Kelowna, BC, Canada.
| | - Lise Olsen
- School of Nursing, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Nelly D Oelke
- School of Nursing, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Helen Sharp
- School of Nursing, University of British Columbia Okanagan, Kelowna, BC, Canada
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Yoong SQ, Wang W, Seah ACW, Gan JON, Schmidt LT, Zhang H. The experiences of nursing students participating in a student death doula service-learning program in palliative care settings: A qualitative study. DEATH STUDIES 2024:1-11. [PMID: 38587973 DOI: 10.1080/07481187.2024.2337205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Nursing students desire more training and experience in palliative care due to a need for more skills and knowledge. This descriptive qualitative study explored nursing students' experiences in participating in a student death doula service-learning program in palliative care settings. Fourteen final-year undergraduate nursing students participated in semi-structured focus group discussions via Zoom. Four focus group discussions were conducted. Six themes with 19 subthemes were developed: (1) initial feelings of fear and uncertainty, (2) death doula training and orientation, (3) palliative wards being a happier place than expected, (4) experience of watching their patients deteriorate over time, (5) benefits of participating in service-learning in palliative care settings, and (6) improving the service-learning experience. The program was well received by the nursing students, who recommended incorporating it into the nursing curriculum to enhance palliative nursing education. Additional refinements were proposed to better support nursing students during service-learning.
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Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Alvin Chuen Wei Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Joanne Oon Nee Gan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Assisi Hospice, Singapore, Singapore
| | - Laura Tham Schmidt
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hui Zhang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- St. Andrew's Community Hospital, Singapore, Singapore
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Yoong SQ, Schmidt LT, Chao FFT, Devi KM, Wang W, Zhang H. Nursing students' perspectives and learning experiences of participating in a palliative and end-of-life care simulation programme: A qualitative study. NURSE EDUCATION TODAY 2024; 134:106103. [PMID: 38277759 DOI: 10.1016/j.nedt.2024.106103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/01/2024] [Accepted: 01/18/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Simulation-based learning has become an integral part of the nursing curriculum, allowing students to acquire clinical knowledge and relevant skills and apply them to real-life clinical encounters. However, little is known about the best practices in palliative and end-of-life care simulations. OBJECTIVE To explore the perspectives and learning experiences of undergraduate nursing students participating in a newly developed advanced practice nurse-led palliative and end-of-life care simulation program. DESIGN A descriptive qualitative study based on focus group discussions. SETTINGS A healthcare simulation centre at a university in Singapore. PARTICIPANTS A purposive sample of 75 third-year undergraduate nursing students who had attended a palliative and end-of-life care simulation program. METHODS Eight face-to-face focus group discussions were conducted and audio recorded. Data were analysed using inductive thematic analysis. RESULTS Four themes encompassing 12 subthemes were derived: (1) Patient, family and caregiver needs during palliative and end-of-life care, (2) Nursing competencies in palliative and end-of-life care, (3) Experience of palliative and end-of-life care simulations and (4) Suggestions for future palliative and end-of-life simulations. The students expressed their support for including advanced practice nurses as facilitators and suggested the use of other simulation modalities such as virtual simulations to enable the participation of all students and provide a wider range of simulated scenarios. CONCLUSIONS Simulation-based learning plays a crucial role in the palliative care curriculum. Clinical experts should be involved as facilitators to provide essential insights. It is also vital to consider students' prior experiences with death and dying, which may positively or negatively influence their palliative and end-of-life care competencies. RECOMMENDATIONS Nursing schools should utilise clinical experts and other simulation modalities to improve students' learning experiences, provide more simulation experiences and overcome resource constraints such as limited curriculum time.
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Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Laura Tham Schmidt
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Felicia Fang Ting Chao
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore.
| | - Kamala M Devi
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Wenru Wang
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Hui Zhang
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; St Andrew's Community Hospital, Singapore.
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