Available online 2 December 2023

Author links open overlay panel, AbstractBackground

Hospice and palliative care are generally not taught in medical or nursing schools.

Aim

The study aimed to discover the palliative care self-competence of pre-licensure nursing faculty and to establish if the palliative care competencies from the American Association of Colleges of Nursing are utilized within nursing programs in the United States (U.S.).

Methods

Surveys (1710) were emailed to accredited programs using a systematic sampling plan, yielding a 4.3% response rate.

Results

Participants (N = 73), with 42% from associate degree (ADN) programs and 58% from baccalaureate (BSN) programs, reported they possessed the ability to meet the 17 palliative care competencies. Still, only ten of the 17 competencies were included in at least 75% of the programs. There were no statistically significant differences in perceived competence between faculty that taught in ADN compared to BSN programs (p = 0.138). A weak to moderate relationship was found between the faculty participants' reported palliative care self-competency and the presence of palliative care competencies in pre-licensure nursing programs in the U.S.

Conclusions

The results suggest that faculty need staff development and display an urgency to re-invigorate the promotion of palliative care nursing education for faculty and students.

Section snippetsBenefits and Barriers to Palliative Care Implementation

Three meta-analyses determined that the administration of palliative care improved the quality of life for those with advanced disease or cancer compared to those who did not receive it (Gaertner et al., 2017; Haun et al., 2017; Kavalieratos et al., 2016). Two Cochrane reviews confirmed that early palliative care significantly improved the quality of life for patients with small effect sizes of 0.27 and 0.26 SMD, respectively (Haun et al., 2017; Bajwah et al., 2020).

In addition, the latter

Method

This descriptive, non-experimental study utilized a quantitative survey design. Inclusion criteria included all prelicensure nursing programs accredited by the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE). Demographic information was collected on the type of prelicensure program, participant's role, and zip code region to protect anonymity.

Results

Descriptive analysis revealed that 32 respondents did not teach palliative care and did not meet the inclusion criteria. A total of 73 faculty members met the inclusion criteria and completed the survey, with an overall return rate of 4.3%. Of those, 42% were from ADN programs, and 58% were from BSN programs. Participants were represented in every zip code region as noted in methods. This difference in the numbers of faculty from each program yielded further opportunities for analysis below.

Discussion

Overall, this study demonstrates that while some faculty who teach palliative care include the CARES competencies (AACN, 2016), many do not. A mild to moderate significant relationship was found between the faculty participants' reported palliative care self-competency and the presence of the palliative care competencies in prelicensure nursing programs in the U.S. No previous studies on this topic have been conducted in the U.S.; only anecdotal data and download counts have been available.

Conclusion

This study demonstrated that many programs are not teaching palliative and end-of-life care to the extent needed for generalized nursing care. Faculty can shape palliative care nursing practice through available tools. Expectations from the NCLEX-RN (2023) test plan include providing end-of-life care and education, assessing pain, providing post-mortem care, and intervening for pain (NCSBN, 2023b). No matter what practice area a nurse works in, most nurses will experience patient death.

CRediT authorship contribution statement

Helen M. Condry: Conceptualization, Data curation, Writing – original draft, Investigation, Formal analysis, Resources, Funding acquisition, Visualization. Julia Aucoin: Supervision, Methodology, Writing – review & editing, Project administration.

Declaration of Competing Interest

The authors declare that they have no known competing personal relationships or financial interests that may have influenced the study reported in this paper.

Funding

This study was funded through a grant from Sigma Gamma Omicron-at Large Chapter of Sigma Theta Tau International Honor Society of Nursing. In addition, Dr. Betty Ferrell graciously offered free tokens for a 1-year faculty access for the End-of-Life Care Consortium curriculum for faculty members who completed the survey.

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