J Hosp Palliat Nurs 2019 08;21(4):272-279
Kristine J. Harrington, DNP, RN, AGNP-C, is palliative care nurse practitioner, Providence Cancer Institute Franz Clinic, Providence Portland Medical Center; and adjunct professor, University of Portland School of Nursing, Oregon. Mary Lou Affronti, DNP, RN, MHSc, ANP, is associate professor, Duke University School of Nursing; primary investigator and nurse practitioner, Preston Robert Tisch Brain Tumor Center; and primary investigator and nurse practitioner, Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina. Susan M. Schneider, PhD, RN, AOCN, FAAN, is associate professor, Duke University School of Nursing, Durham, North Carolina; and president, Oncology Nursing Society, Pittsburgh, Pennsylvania. Abdul Rab Razzak, MD, is director of outpatient palliative care, Johns Hopkins Medical Institutions, Baltimore, Maryland. Thomas J. Smith, MD, FACP, FASCO, FAAHPM, is director of palliative care, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Nurses play an integral role in high-quality patient care. Thus, their skills in providing end-of-life care should be assessed and continually enhanced. Education intended to improve end-of-life skills must address the affective/emotional component of nursing care. Evidence demonstrates that emotional engagement and resilience among health care providers are correlated with improved quality outcomes and, conversely, that burnout and stress negatively affect patient safety. Addressing the emotional needs of health care providers is critical to improving quality throughout the health care system. An evidence-based workshop was implemented among direct care staff on a hospital-based palliative care unit, with the goal of fostering emotional engagement to improve staff perceptions and attitudes about caring for patients at or near the end of life. Although perceptions about quality of death were not affected by this intervention, there was a significant improvement in attitudes about end-of-life nursing care. Qualitative feedback also reflected appreciation for small group discussions and opportunities to debrief with peers away from the unit. This intervention reflected the value of emotional engagement in educational efforts to improve end-of-life nursing care.