Improving the Quality of Life
developing an advanced practice palliative care nursing specialty - spring 2007
By Joshua Jensen
People come to Boston from across the world for cutting-edge, life-saving healthcare. But amid aggressive treatment that can sometimes last many months and even years, where do people turn to address the many side effects and debilitating symptoms that often accompany chronic and terminal illness?
Some may turn to advanced practice nurses with specialization in palliative care.
For many years palliative care has been thought of as an alternative to curative treatment, or something that is chosen when all other treatment options have been exhausted. However, this attitude
is rapidly changing. A newer approach dictates palliative care for the patient beginning hand in hand with treatment for chronic conditions.
According to Patricia Tabloski, Associate Dean of Graduate Programs at the Connell School, “The healthcare community is finally beginning to realize the importance of beginning palliative care as early as possible, alongside curative treatment.”
Katherine Tardiff, Project Coordinator for the Connell School’s Palliative Care Program, explains, “Over time, the experience of serious illness, death, and dying has evolved. People used to die sooner, but in the relative comfort of their own homes. As technology has improved, heathcare began to focus more on the cure, sometimes in lieu of comfort.”
According to Tardiff, demographic shifts are helping to move the focus toward comfort. “Baby boomers have seen their own parents experience aging and chronic illness. As they age themselves, they are beginning to think about what they want the next phase of their lives to look like. This is one factor that is driving the emphasis on quality of life, and in turn, palliative care.”
Tardiff sees advanced practice nurses as central to providing this care. “The nursing role is already focused on the fundamentals of palliative care—educating the patient and family, providing support, explaining the illness trajectory, and acting as a liason between the interdisciplinary healthcare team.”
This might make intuitive sense, but there is little opportunity for advanced practice nurses to get appropriate graduate education
in palliative care, let alone develop specialization in this emerging field. Nationally, there are only a handful of nursing schools offering advanced practice nurses the opportunity to specialize in palliative care, and no existing programs in the Boston area.
To meet this need, Tabloski won a grant for more than $725,000 to develop a Palliative Care Nursing specialty at the Connell School. Funded by the Health Resources and Services Administration (HRSA), part of the U.S. Department of Health and Human Services, the Palliative Care specialty is currently enrolling students and will start offering courses this summer.
Tardiff sees a strong fit between the BC faculty and this new program. “The team of professors designing and teaching the palliative care curriculum has broad expertise: Margie Laccetti and Jane Flanagan in oncology; Rosanna DeMarco with HIV and community health issues; Judi Vessey in program evaluation; and Pat Tabloski in the area of geriatric nursing and dementia.”
“Of course, the connection between BC’s Jesuit mission and palliative care is obvious,” Tardiff notes. “The Jesuit commitment to care of the individual and to serving the needs of underserved populations are mirrored nicely in the focus of the palliative care program.”
Tabloski agrees that this is a strong fit for the Connell School. “This grant is an opportunity for Boston College to take a leadership role in a growing area of healthcare, and one that is at the heart of the nursing profession. I’m excited to be able to offer this opportunity to our students and to the nursing community.”
palliative care courses
NU 640 Palliative Care I: Foundations of Serious Illness, Disease Progression and Quality of Life
An historical, sociopolitical and cultural perspective of the personal, professional, societal, cultural, spiritual, and ethical/legal issues related to serious illness and the end of life. Philosophy, principles, and models of palliative care are analyzed, as well as the role of the advanced practice nurse and others in a caring society.
NU 641 Palliative Care II: Pain and Suffering in the Seriously Ill Patient
Focus is on improving the quality of life of individuals and families as they experience life-threatening illness, through nursing assessment and interventions. Issues include pain management, improving quality of life, alleviating suffering and evaluation of outcomes using established palliative care standards.
NU 642 Palliative Care II: Practicum
Prepares students to provide comprehensive care to patients and their families with advanced life-threatening illness. Students engage in holistic assessment of pain and quality of life of patients with advanced illness including AIDS, cancer and serious illness in a variety of settings under the direction of a skilled clinician in palliative care. Seminars integrate concepts from the core and theory courses.
NU 643 Palliative Care III: Palliative Care and the Advanced Practice Nursing Role
Students analyze the impact of serious life-threatening illness on patient, family, community and the health care system. Resource availability and barriers to care are analyzed. The leadership role of the advanced practice nurse in palliative care is delineated with emphasis on policy development, protocols, standards of practice, fiscal management, research utilization, quality improvement, patient advocacy, ethics, social-cultural issues and the role of the nurse leader in the interdisciplinary team.
NU 644 Palliative Care III: Practicum
Prepares students to integrate advanced knowledge of palliative care in assessing and managing the symptoms of those experiencing life-threatening illness within the palliative care focus. Complex psychological, ethical, social and spiritual issues and grief reactions will be the focus of the clinical practicum.