institutional change, nursing roles, palliative care, program development



  1. Grant, Marcia DNSc, RN, FAAN
  2. Hanson, Jo MSN, RN, CNS, OCN


Demand for expert palliative and end-of-life care has far outpaced the availability of specialty trained healthcare providers and the unique programs required to address this need. Educating healthcare professionals is a first step in meeting this palliative and end-of-life call. This article describes a palliative and end-of-life care professional education course and discusses successful nurse-led team projects initiated after the course. Two-person interdisciplinary healthcare teams from nationwide cancer centers were trained to recognize and care for the special needs of the palliative and end-of-life patient population. Following a 3-day course, 199 teams returned to their institutions to implement customized goals for improving patient care. Long-term follow-up evaluation provided examples of teams with nurse members who were successful in initiating palliative care culture changes and in developing/fine tuning palliative and end-of-life care programs. The increasing need for new and expanding palliative and end-of-life programs continues. Nurses are especially adept in developing/monitoring new programs, at leading institutional culture changes, and in addressing palliative and end-of-life patient needs. Harnessing the expertise of professional nurses to lead new programs offers a practical strategy in addressing the many critical opportunities for palliative and end-of-life care.