Ensuring that your institution or clinical setting provides primary palliative care is one of the most powerful ways you can improve the quality and cost of U.S. healthcare. However, most health care professionals have not been trained to provide this type of care, and they cannot practice what they do not know. Since nurses are the largest group of healthcare professionals, and the ones who spend the most time at the patients’ bedsides, is it critical to educate nurses in primary palliative care. This will result in improved quality of care to patients and families, lower hospital costs, minimize moral distress, and improved nurse retention rates.
Defining the Solution
Palliative care is patient and family‐centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care involves addressing physical, intellectual, emotional, social, and spiritual needs throughout the continuum of illness, from diagnosis of a serious illness to end of life. It also facilitates patient autonomy, access to information, and choice. This “intensive care” results in medical decision making that aligns with patients’ wishes and goals of care, creating added benefits of decreased unwanted ICU and emergency room admissions, controlled re-admission rates, improved patient and family satisfaction, as well as improved quality of life for those with serious illness and their families.
People who are seriously ill constitute only 5-10% of patients, yet total more than half of the nation’s total healthcare costs. Ten percent of Medicare beneficiaries with 5 or more co-morbid illnesses account for 2/3 of our total Medicare spending and most patients with serious illness have many co-morbid conditions. Seventy-six percent of the national Medicaid budget goes to acute hospital services, the most expensive setting of care. Palliative care could decrease these expenditures while improving the quality of care these patients receive.
Because “primary palliative care” is a relatively new concept, it is important to understand all the necessary components:
- Evidence-based management of common types of pain and symptoms
- Strong communication skills that facilitate difficult discussions around advance care planning, goals of care, and issues of advanced disease
- Knowledge about hospice and specialty palliative care services, eligibility, and access.
Care in Action
It is within the scope of practice of the registered nurse to hold advance care planning and goals of care conversations, advocate for improved pain and symptom management, and educate patients and families about their options for quality end-of-life care. However, nurses cannot practice what they do not know - they must be educated in primary palliative care. Once educated, nurses can improve the quality of care for many with common serious illnesses who do not necessarily need specialty care or do not have access to it.
How can this education reach large numbers of nurses in a timely, cost-effective manner? The answer is online education with the End-of-Life Nursing Education Consortium (ELNEC) Curricula. Nurses can complete this education on their own time, at their convenience, without costly travel and registration fees for a national conference training. They receive basic palliative care knowledge and skill training, continuing education credits, and a certificate that acknowledges they have been ELNEC- trained.
ELNEC has been teaching nurses palliative care since 2001 and has both national and international recognition for its success. Four different curricula are available online to practicing nurses:
- ELNEC- CORE
- ELNEC- Critical Care
- ELNEC- Pediatrics
- ELNEC- Geriatrics
Each one is specific to the nurses’ specialty. Make sure nurses at your institution receive this valuable education and help improve the quality of healthcare for those with serious illness in the U.S.
Do your part: learn more about the ELNEC courses and how to access them.