Education and end-of-life care

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So I remember that I didn't really have to much in terms of education about end of life care in nursing school. And if it was, it was probably covered in a lecture that was 5 minutes. I know this can be a touchy subject for many on both the patients and nurses end. Much of the emotion behind dying can be ethical, religious and from personal experience. It just seems as though that new grads out of nursing school receive little to no training in dealing with this aspect of care because for those that work at the bedside, you will eventually have to deal with this situation. Most schools of thought regard end-of-life as a failure in the system of medicine and regard it with a certain stigmatism.

What are your thoughts? Do you think their should be more formal education on the matter? More training in the form of CE or certification? Or you think experience is the better teacher and for new grads its trial by fire?

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Specializes in IMC, school nursing.

In general, the U.S.'s approach to nursing education has flipped 180 degrees from 30 years ago. You learn theory only, little practical application. It is up to your employer to teach you the what to the why you learned in nursing school. Americans, in general, want a sterile process to the dying process and death. Put it off as long as possible and do it outside the home and remember the person without viewing the body. Home hospice is a beautiful process that takes us back to the way it should be. Few choose it. I enjoy hospice nursing, I feel, after decades of saving lives, that instead, I am saving people. Not giving them life, but letting them live their lives that they have left. There is plenty of info out there for the pathophysiology of death, this is the attitude that makes you effective.

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Maybe a CEU for the physiological process of death and what can be done to make the patient more comfortable. However, my end of life experiences have been incredibly varied based off of the family's beliefs and values. Unfortunately I think the actual process of walking a family member or a patient through end of life is just something you get better with experience

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Home hospice seems like a great thing based on the idea and what i've heard. My experience is only limited to the hospital. I would think if you had a terminal illness and you didn't require much resources in the form of hospital equipment, you would rather die in the comfort of your own home.

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Specializes in IMC, school nursing.
I would think if you had a terminal illness and you didn't require much resources in the form of hospital equipment, you would rather die in the comfort of your own home.

Unfortunately, it is uncomfortable for many people. I realized it was the best when my Kindergartner said goodbye to his grandfather giving his final breath and minutes later my son was picked up to go to school. The real issue that shows where most people believe on this came months later when neighbors would not go downstairs where his room was because "that's where he died". The preoccupation with ghosts, perpetuated by Travel Channel and its ilk is instilling the need to die outside the home. My brother said he would never want someone to die in his house. Most feel this way.

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Specializes in Nursing Professional Development.

It varies from school to school ... and what the interests of the particular faculty are. 40 years ago, my BSN program included a whole lot of content on elder care and death/dying. We had one of the leading experts in that field on our faculty.

I went to an MSN program that really big on staff development -- that regardless of your specific nursing specialty, it would be your responsibility to teach/lead the younger generation. But then, the university had a really big Adult Education Department and a lot of the nursing faculty had taken some classes there.

I went to a PhD program where Jean Watson was on the faculty as well as a couple of nurse philosophers. So yes, we focused more attention on caring and philosophy than some other PhD programs.

That's another reason to consider your choice of school carefully. The faculty determines what is emphasized in the curriculum and what is not. That's their job. I am happy that my BSN program included so much on death and dying as I think it is an important topic for nurses.

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Specializes in IMC, school nursing.
It varies from school to school ... and what the interests of the particular faculty are. 40 years ago, my BSN program included a whole lot of content on elder care and death/dying. We had one of the leading experts in that field on our faculty.

I went to an MSN program that really big on staff development -- that regardless of your specific nursing specialty, it would be your responsibility to teach/lead the younger generation. But then, the university had a really big Adult Education Department and a lot of the nursing faculty had taken some classes there.

I went to a PhD program where Jean Watson was on the faculty as well as a couple of nurse philosophers. So yes, we focused more attention on caring and philosophy than some other PhD programs.

That's another reason to consider your choice of school carefully. The faculty determines what is emphasized in the curriculum and what is not. That's their job. I am happy that my BSN program included so much on death and dying as I think it is an important topic for nurses.

No offense, but 40 years ago, nursing programs taught the what much more than the why. Even BSN programs. The theory put to application is where new grads are having issue, I saw it every day on the floor. I saw it when the students came on the floor. The US has the highest educated nurses that can not do many procedures.

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Specializes in Nursing Professional Development.
No offense, but 40 years ago, nursing programs taught the what much more than the why. Even BSN programs. The theory put to application is where new grads are having issue, I saw it every day on the floor. I saw it when the students came on the floor. The US has the highest educated nurses that can not do many procedures.

That's exactly what they said about the nurses of my generation -- that we had too much theory (about death and dying and stuff like that) and not enough physical skills.

There is no way for any program to teach everything. So pick one that focuses on the things that interest you the most. Then ... commit to life-long learning to continue to grow after graduation.

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