Palliative care and end-of-life content are integrated throughout the University of Rochester School of Nursing’s undergraduate and graduate nursing curricula in clinical, ethical, policy, and theory coursework. In addition, the School of Nursing offers a hospice and palliative care elective. Students have the opportunity to interact with members of the palliative care team, attend palliative care rounds, and investigate palliative care and hospice care as delivered at home and in institutional settings.
The School of Nursing core curriculum on end-of-life (EOL) care focuses on the following content modules.
- Pain Management: Definitions of pain, current status of and barriers to pain relief, components of pain assessment, specific pharmacological, and non-pharmacological therapies including concerns for special populations.
- Symptom Management: Detailed overview of symptoms commonly experienced at the EOL, and for each, the cause, impact on quality of life, assessment, and pharmacological/non-pharmacological management.
- Ethical/Legal Issues: Recognizing and responding to ethical dilemmas in EOL care including issues of comfort, consent, prolonging life, withholding treatment; euthanasia, and allocation of resources; and legal issues including advance care planning; advance directives, and decision making at EOL.
- Cultural Considerations: End-of-life care, multiple aspects of culture and belief systems, components of cultural assessment with emphasis on patient/family beliefs about roles, death and dying, afterlife, and bereavement.
- Communication Essentials: Communication at EOL, attentive listening, barriers to communication, breaking bad news, and interdisciplinary collaboration.
- Nursing Care at the End of Life: Overview of death and dying in America, principles and goals of hospice and palliative care, dimensions of and barriers to quality care at EOL, concepts of suffering and healing, role of the nurse in EOL care.
- Grief, Loss, Bereavement: Stages and types of grief, grief assessment and intervention, and the nurse's experience with loss/grief and need for support.
- Achieving Quality Care: End-of-life challenge for nursing in EOL care, availability and cost of EOL care, the nurses' role in improving care systems, opportunities for growth at EOL, concepts of peaceful or "good death," "dying well," and dignity.
- Preparation and Care: Time of death nursing care at the time of death including physical, psychological, and spiritual care of the patient, support of family members, the death vigil, recognizing death, and care after death.