Course Code: REL-PAC-ELNEC-CCMFINHR
Hours: 1.5
Type: Online Course
Content Expiration Date: 12/31/2026
Learning Objectives:
Describe five physical signs and symptoms of the dying process and the important areas of assessment.
Discuss the important physical, psychological, social, cultural, and spiritual care needs of the patient nearing death and their family.
Recall the role of the critical care nurse in the death of a patient.
Outline:
Section 1: Introduction
About This Course
Learning Objectives
Section 2: Preparing for a Good Death
A Good Death
Serious Illness in the Critical Care Setting
Witnessing A Good Death
Preparing for Death: Advance Care Planning
The Critical Care Nurse
Open, Honest Communication
Importance of Being Honest
Individualized, Personal Experience
Promoting Quality End-of-Life Care in Critical Care Settings
Medically Administered Nutrition and Hydration
Resuscitation
Discontinuation of Cardiac Devices and Treatment
Discontinuation of Respiratory Ventilation
Discontinuation of Dialysis
Organ and Tissue Donation
Dignity Conserving Care
Hastened Death Request
Psychological Changes
Spiritual and Cultural Considerations
Review
Summary
Section 3: Symptoms Associated With Imminent Death
Signs and Symptoms
Most Common Symptoms
Medication Management
Pain During the Final Hours
Myoclonus
Symptoms of Imminent Death
Controlled Sedation, Palliative Sedation, or Sedation for Uncontrolled Symptoms
Discontinuation of Life-Sustaining Therapies
The Death Vigil
Review
Summary
Section 4: Bereavement Care
Care Following Death
Care and Respect of the Body
Bereavement Support
Remember the Children
Review
Summary
Section 5: Conclusion
Course Summary
Course Contributors
Resources
References
Subject Matter Expert: 2023 ELNEC Critical Care Series
The content for this course was written by The ELNEC Project Team.
The ELNEC Project, which began in 2000, is a collaboration between City of Hope, Duarte, CA and the American Association of Colleges of Nursing (AACN), Washington, DC. For more information about ELNEC, go to www.aacnnursing.org/ELNEC
The content for this course was revised by:
Constance Dahlin, MSN, ANP-BC, ACHPN®, FPCN, FAAN has focused her career within hospice and palliative care. She has experience in administration of programs, program development, curricula development, education of the interprofessional team, and clinical practice in the home, clinic, long term care setting, rehabilitation setting and the acute care setting.. Currently, she is faculty here at University of Maryland Baltimore PhD, Master of Science and Graduate Certificate in Palliative Care, a consultant to the Center to Advance Palliative Care (CAPC) in community-based care and education, co-director of the Palliative APP Externship, with a clinical practice as a palliative nurse practitioner at Salem Hospital and. She serves as national faculty for the End-of-Life Nursing Education Consortium (ELNEC), the American Hospital Association Circle of Life Committee, the Massachusetts Serious Illness Coalition Nursing Taskforce, and the Massachusetts Comprehensive Cancer Steering Committee.
Ms. Dahlin authored several editions of the Palliative Nursing: Scope and Standards and Competencies for the Palliative and Hospice RN, and APRN. She wrote the Hospice and Palliative APRN Professional Practice Guide and A Primer of Reimbursement, Billing, and Coding: Essential Information for the Hospice and Palliative APRN. She is coeditor of the Oxford University Press Advanced Practice Palliative Nursing 1st and 2nd editions. She referenced the 2004 first education of the National Consensus Project’s Clinical Practice Guidelines for Palliative Care and edited the 2009 second and third 2013 editions.
Ms. Dahlin served on the Measurement Applications Partnership PAC/LTC Workgroup, the Measurement Applications Partnership Clinician Workgroup within the National Quality Forum and co-chaired the Massachusetts Comprehensive Cancer Control and Prevention Network Palliative Care Workgroup. Ms. Dahlin is a Fellow of Hospice and Palliative Nursing, a Fellow of the American Academy of Nursing, a 2005 Certified ACHPN APRN of the year, a 2016 recipient of a Sojourns Cambia Health Foundation Sojourns Leadership Scholar Award, a 2018 American Academy of Hospice and Palliative Medicine Visionary in Hospice and Palliative Medicine, the 2020 HPNA Distinguished Practice Award and the 2021 University of Maryland Baltimore Master of Science and Graduate Certificates in Palliative Care Teacher of the Year. She completed her MSN in oncology nursing and her post-masters in adult primary care at the MGH Institute of Health Professions. She has authored peer reviewed articles, chapters and curricula and presented nationally and internationally.
Judith Paice, PhD, RN is the Director of the Cancer Pain Program in the Division of Hematology-Oncology and a Research Professor of Medicine, Northwestern University, Feinberg School of Medicine. She is also a member of the Robert H. Lurie Comprehensive Cancer Center. Dr. Paice is presently a member of the NIH HEAL Initiative Multidisciplinary Working Group and has served as President of the American Pain Society and Secretary of the International Association for the Study of Pain. Currently a panel member of the NCCN Adult Cancer Pain Clinical Practice Guideline, much of Dr Paice’s clinical work has been in the relief of pain associated with cancer. She has traveled widely within six continents to educate health care professionals regarding cancer pain relief and palliative care. Dr. Paice serves on the editorial board of the Journal of Pain, Journal of Pain and Symptom Management and Journal of Clinical Oncology and is the author of more than 170 scientific manuscripts. She was one of the original consultants in the End-of-Life Nursing Education Consortium (ELNEC) and has continued serving as a faculty member in this program. In 2018, Dr. Paice was named one of the 30 Visionaries in the field by the Academy of Hospice and Palliative Care.
Target Audience:
The target audience for this course is: Nurses; in the following settings: Hospice, Palliative Care.
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All courses offered by Relias Learning, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.