Abstract

End-of-life discussions can be difficult for patients, their families, and clinical nurses. Yet, studies have shown that early end-of-life discussions increase patient/family acceptance of the illness as terminal, promote satisfaction and involvement with end-of-life care, and have the potential to reduce emergency department visits, hospital admissions, and length of stay. This pre-/post- evidence-based practice implementation aimed to improve clinical nurses' confidence in initiating and participating in end-of-life discussions with patients and families. A pre-survey created by the author and subject-matter experts was distributed via an electronic survey to nurses on an acute care, oncology unit before attending a 2-hour continuing education activity. The pre-survey revealed that nine of 12 nurses had received therapeutic communication training in the past, 50 percent had had end-of-life conversations, and nine of 12 nurses agreed. The training included information regarding differentiating between palliative care and hospice, the literature surrounding barriers to end-of-life conversations, and three case scenarios with an open discussion among the attendees. Two weeks after the training, the nurses attending the training were sent the post-survey to complete. The post-survey revealed that 100% of the 12 nurses surveyed were able to name at least one benefit of end-of-life conversations. The average scores on the questions regarding comfort with initiating end-of-life conversation and comfort with discussing end-of-life in general increased by 53% and 20%, respectively. The survey included an open-ended question asking the participants to describe their discussions using the communication techniques taught. Examples of the description were as follows: "I used it to gauge how much a family knew about a diagnosis. Went well and opened up a very good discussion," and " I hand the opportunity to discuss the dying process with a family member this that was concerned about what was being done. It was a good conversation and was reiterated by the hospice nurse." In conclusion, teaching nurses about end-of-life issues and therapeutic communication surrounding disease processes and dying benefits the nurse and the patient. We plan to expand the training to other units to enhance the care given to our dying patients and their families.

Notes

Target Audience: Clinical, Leaders, and Researchers

Themes: Non-academic and Ethics

Author Details

Mary Ann Villano, BSN, RN, RN-BC Houston Methodist Willowbrook, Houston, TX, USA, and

Denise McNulty, DNP, RN, MS-HSA, NPD-BC, NE-BC Center for Professional Excellence, Houston Methodist Willowbrook, Houston, TX, USA

Sigma Membership

Iota Nu at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

End of Life Care, Communication, Medical/Surgical Nurses

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Austin, Texas, USA and Virtual

Conference Year

2023

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-10-13

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Talking About Dying: Enhancing Comfort With End-of-Life Conversations With Patients and Families

Austin, Texas, USA and Virtual

End-of-life discussions can be difficult for patients, their families, and clinical nurses. Yet, studies have shown that early end-of-life discussions increase patient/family acceptance of the illness as terminal, promote satisfaction and involvement with end-of-life care, and have the potential to reduce emergency department visits, hospital admissions, and length of stay. This pre-/post- evidence-based practice implementation aimed to improve clinical nurses' confidence in initiating and participating in end-of-life discussions with patients and families. A pre-survey created by the author and subject-matter experts was distributed via an electronic survey to nurses on an acute care, oncology unit before attending a 2-hour continuing education activity. The pre-survey revealed that nine of 12 nurses had received therapeutic communication training in the past, 50 percent had had end-of-life conversations, and nine of 12 nurses agreed. The training included information regarding differentiating between palliative care and hospice, the literature surrounding barriers to end-of-life conversations, and three case scenarios with an open discussion among the attendees. Two weeks after the training, the nurses attending the training were sent the post-survey to complete. The post-survey revealed that 100% of the 12 nurses surveyed were able to name at least one benefit of end-of-life conversations. The average scores on the questions regarding comfort with initiating end-of-life conversation and comfort with discussing end-of-life in general increased by 53% and 20%, respectively. The survey included an open-ended question asking the participants to describe their discussions using the communication techniques taught. Examples of the description were as follows: "I used it to gauge how much a family knew about a diagnosis. Went well and opened up a very good discussion," and " I hand the opportunity to discuss the dying process with a family member this that was concerned about what was being done. It was a good conversation and was reiterated by the hospice nurse." In conclusion, teaching nurses about end-of-life issues and therapeutic communication surrounding disease processes and dying benefits the nurse and the patient. We plan to expand the training to other units to enhance the care given to our dying patients and their families.