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The
ELNEC core curriculum has been developed to prepare qualified nurse educators
to provide end-of-life education for nursing students and practicing nurses, and
to provide resources to facilitate that instruction. These educators in turn will
use the curriculum to integrate end-of-life content for students in undergraduate
nursing programs, and offer staff development/continuing education programs for
clinical nurses who provide end-of-life care. Curriculum
and course development occurred during the period February 2000 - January 2001
under the guidance of City of Hope National Medical Center investigators Betty
Ferrell, PhD, RN, FAAN and Marcia Grant, DNSc, RN, FAAN. The curriculum was developed
in collaboration with four nationally recognized end-of-life care experts:
- Patrick
Coyne, MSN, RN, CHPN, Medical College of Virginia Hospitals at Virginia Commonwealth
University
- Kathy
Egan, MA, RN, CHPN, The Hospice Institute of the Florida Suncoast
- Judith
Paice, PhD, RN, FAAN, Northwestern University Medical School, and
- Joan
Panke, MA, RN, APRN, Executive Director, DC Partnership to Improve End-of-Life
Care
- 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.
- 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 in EOL 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 of communication at EOL, attentive listening, barriers to communication,
breaking bad news, and interdisciplinary collaboration.
- 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 at the 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 for the 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.
Specifications
for Use of the ELNEC Core Curriculum by ELNEC Trainers
Participants
who complete a national ELNEC core course sponsored either
by AACN/City of Hope or Last Acts are considered ELNEC Trainers,
part of a national network of specially-prepared nurse educators
who are qualified to teach ELNEC content to others. A list
of these ELNEC Trainers is maintained on the ELNEC Web
site in order to facilitate collaboration with and among ELNEC
Trainers. In addition, local trainer courses are held around
the country. While considered ELNEC Trainers, these "second
generation" trainers are not listed on the national trainer
list, but may sponsor training activities as described below.
ELNEC Trainers may incorporate ELNEC content into already-developed
programs, or create new educational activities for specific
audiences. They are expected to use ELNEC materials, and may
adapt the materials as described in the ELNEC
Copyright Permission. ELNEC Trainers must coordinate educational
activities, but may utilize other qualified faculty as appropriate.
Educational activities fall into the following categories.
- End-of-Life
Education. This consists of short programs of less than nine hours, and/or
less than all nine ELNEC modules. These short end-of-life care courses may have
a variety of general titles (E.g., end of life care), but may not be called ELNEC
training.
- ELNEC
Training. Any educational activity that utilizes ELNEC core materials,
includes all nine ELNEC modules, and consists of a minimum of one hour per module
for a total of nine hours is considered "ELNEC Training." These programs
must be coordinated through the ELNEC Project Office so that the integrity of
the ELNEC curriculum is assured, and the Project Office is aware of the ELNEC
training occurring around the country. Those who complete this type of program
may be designated as "ELNEC Trained". Although interdisciplinary audiences
and students often are invited to these courses, ELNEC training is primarily designed
for registered nurses. Non-RN nursing students may not receive this designation.
- Trainer
Conferences or Train-the-Trainer Programs. These are two or three-day
conferences designed to teach a group of professional nurses to become trainers
of the ELNEC core curriculum, usually within a specific health care system or
geographic area. Participants who complete the program are designated as "ELNEC
Trainers", although they are not part of the national network described above.
In these trainer courses, all nine modules must be covered, with a minimum of
one hour devoted to content and roughly one hour devoted to teaching strategies
and resources for each module. Requests to host this type of course are individually
considered, and courses are planned in close collaboration with the ELNEC Project
Office. Sponsorship of trainer courses is not authorized unless this prior coordination
has occurred.
- Nontraditional
Activities. Although ELNEC Trainers are encouraged to use creative approaches
to teach this specialized content, in-person classes are the preferred vehicle.
Any other proposed use must be coordinated in advance through the ELNEC Project
Office. This includes posting on an agency intranet, offering classes via distance
technology, preparing self-study materials, or an entrepreneurial approach. ELNEC
content may not be posted to the Internet or published by ELNEC Trainers.
For
further information or questions, contact Pam Malloy at (202) 463-6930 extension
238 or pmalloy@aacn.nche.edu. |
