Program preps nurses in primary, palliative careby Cindy AbolePublic Relations Blending the right combination of knowledge and skills in the areas of primary and palliative care is the aim of a newly expanded graduate nursing program that will help prepare adult nurse practitioners to meet the needs of South Carolina’s patients with life-limiting diseases or terminal illness. The program was established thanks to a three-year, $600,000 funded grant to establish a graduate-level palliative care curriculum through MUSC’s College of Nursing. The grant was initiated by associate professor Barbara Edlund, Ph.D., R.N., and was awarded this July by the Bureau of Health Professions/Health Resources Services Administration (HRSA)’s Division of Nursing. “We’re excited the program got funded,” said Edlund, who is also the grant’s principal investigator. “Palliative care has been recognized nationally as a critical health issue. What this grant provides is the necessary education and clinical expertise to ensure that people are provided with the symptom management they need, even through death. The blending of both primary and palliative care is an innovative and creative way to address the total needs of adults and their families.” Edlund’s interest was sparked after receiving an American Nurses Credentialing Center (ANCC) flyer in 2001 promoting the group’s offering in a new certification exam in palliative care. Looking further, Edlund discovered there were only three masters programs in the country offering graduate-level curriculum preparing nurses in palliative care. The move followed a growing trend by health professionals for board certification of specialists in this area of care. “Offering this type of certification for nurses was very new advanced practice nursing,” Edlund said. “It gave programs a lot of latitude in coordinating training and preparation programs for nurse specialists and practitioners.” Fueling this attitude for change was a local movement by Tri-county area hospitals and other care facilities towards palliative care and hospice. MUSC’s Supportive and Palliative Care Program was established as a support program focused on easing suffering and handling quality-of-life issues for patients and their families. Neighboring Roper Hospital is also on the verge of establishing a similar service for their patients. Last year, the Ralph H. Johnson VA Medical Center along with VA hospitals across the country were directed to create palliative care programs and one has since been initiated. Meanwhile, Hospice of Charleston, the Lowcountry’s first hospice care provider, unveiled plans to build a new $3 million hospice facility to support the area’s most seriously ill patients. “Seeing this local movement towards palliative care helped validate our efforts with this grant creating a novel curriculum to prepare adult nurse practitioners in this dual specialty who would serve rural areas around the state,” Edlund said. Forty-five of the Palmetto state’s 46 counties are designated as medically underserved. According to Edlund, people diagnosed with medical problems and living within rural areas have a more difficult time maintaining their health. “People can easily fall between the cracks due to limited access to primary care and the absence of specialists in palliative care, ” Edlund said. In preparing the grant, Edlund attended the 2003 End-of-Life Education Con-sortium for graduate nursing faculty sponsored by the American Association of Colleges of Nursing as well as the End-of-Life Physician Education workshop for physicians. Next, she assembled a interdisciplinary team of educators, specialists and clinicians to help develop goals and curriculum content. The group also collaborated with two consultants instrumental in the national palliative care movement: Betty Ferrell, Ph.D., (City of Hope) and Debra Witt-Sherman, Ph.D., R.N. (New York University). Set to begin this fall, the program hopes to attract both local and regional nurse practitioner students. According to Edlund, what distinguishes this program is the opportunity for nurses to specialize in both primary and palliative care—offering an easy transition from primary to palliative care modes based upon the patient and their needs. “Typically, critically ill patients at end-of-life care are sent to the hospital because families and caregivers don’t know what to do,” Edlund said. “It’s tough for an individual to die in an acute care setting where historically the philosophy of nurses and medical personnel is focused on curative measures.” “Palliative care is an extension beyond end-of-life care. People need to recognize a point in the disease process where the transition of care shifts from responding to the patient’s disease to caring for the whole patient,” said Elaine Amella, Ph.D., R.N., associate dean for Nursing Research and co-director and co-investigator of the grant. Amella is a member of the Tri-County End-of-Life Coali-tion, an active assembly of area professionals, practitioners and advocates devoted to increasing the use of advance care plans and improving end-of-life care issues in the Lowcountry. Besides being interdisciplinary, the program also shares a collaborative approach teaming with South Carolina Area Health Education Center to coordinate the placement of participants in statewide clinical sites. Graduates of this program will be prepared to work within a variety of patient care settings from hospitals and health care facilities to rural community health clinics, family practice offices, nursing homes, internal medicine offices and hospices. In addition to supporting staff, Edlund believes these graduates will serve as invaluable nurse-educators for providing palliative care training for all staff. “Their training and expertise can help preserve the individuality and integrity of patients,” Edlund said. “They can really make a difference.” A focus of the grant is devoted to outreach education. Edlund plans to continue supporting CON efforts promoting nursing/health profession careers at high schools and minority institutions, as well as educating students on health and end-of-life issues. CON Adult Nurse Practitioner in Palliative
Care Grant Collaborators
Friday, Aug. 20, 2004
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