Education May Better Equip Nurses to Hold End-of-Life Conversations in Advanced Cancer

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The program helped nurses realize that patient hope was not taken away by having EOL discussions.
The program helped nurses realize that patient hope was not taken away by having EOL discussions.
The following article features coverage from the 2018 Oncology Nursing Society's Annual Conference in Washington, DC. Click here to read more of Oncology Nurse Advisor's conference coverage. 

WASHINGTON, DC — An interactive and didactic in-service may help nurses become better equipped to hold end-of-life (EOL) conversations with patients with advanced cancer, according to a presentation at the 2018 Oncology Nursing Society (ONS) Annual Congress.

Evidence shows that patients with increased understanding of their prognosis make better informed EOL decisions, but approximately half hold EOL discussions with their providers — who were concerned that EOL conversations would take hope away from patients — within 1 month of death. 

“The objectives of my project,” said MaryPat Porinchak, RN, BSN, OCN, “were to determine the knowledge gap among oncology nurses surrounding EOL discussion and identify resources that would help them better facilitate these conversations with their patients. “

For this project, Porinchak implemented a program at Memorial Sloan Kettering Cancer Center to educate outpatient oncology nurses on EOL communication with their patients. The program provided literature on patient outcomes, best practices to address EOL needs of diverse populations, and barriers that prevent EOL discussion. Participants also completed surveys before and after the program to assess changes in their perceptions and knowledge about EOL conversations. 

Results showed that prior to the in-service, nurses felt unsure whether patients' hopes were negatively affected by EOL conversations, but the program helped them realize that hope was not taken away by having these discussions. Moreover, participants stated that they recognized they had a pivotal role in assisting patients understand their prognosis. Importantly, the program also made nurses aware that there are many resources available to assist with EOL conversations. 

The intervention also made the interviewees recognize potential shortcomings; nurses stated that they would need to improve their diversity proficiency when communicating with patients. 

Porinchak concluded that “This short educational intervention demonstrated positive outcomes for nurses and identified future innovation without cost. It could easily be replicated and is an opportunity to identify needs about EOL.”

Reference

Porinchak MP. End-of-life communication in oncology: nurses perceptions, attitudes and challenges. Oral presentation at: ONS 43rd Annual Congress; May 17-20, 2018; Washington, DC.

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