emotional engagement, end-of-life nursing, quality of death



  1. Harrington, Kristine J. DNP, RN, AGNP-C
  2. Affronti, Mary Lou DNP, RN, MHSc, ANP
  3. Schneider, Susan M. PhD, RN, AOCN, FAAN
  4. Razzak, Abdul Rab MD
  5. Smith, Thomas J. MD, FACP, FASCO, FAAHPM


Nurses play an integral role in high-quality patient care. Thus, their skills in providing end-of-life care should be assessed and continually enhanced. Education intended to improve end-of-life skills must address the affective/emotional component of nursing care. Evidence demonstrates that emotional engagement and resilience among health care providers are correlated with improved quality outcomes and, conversely, that burnout and stress negatively affect patient safety. Addressing the emotional needs of health care providers is critical to improving quality throughout the health care system. An evidence-based workshop was implemented among direct care staff on a hospital-based palliative care unit, with the goal of fostering emotional engagement to improve staff perceptions and attitudes about caring for patients at or near the end of life. Although perceptions about quality of death were not affected by this intervention, there was a significant improvement in attitudes about end-of-life nursing care. Qualitative feedback also reflected appreciation for small group discussions and opportunities to debrief with peers away from the unit. This intervention reflected the value of emotional engagement in educational efforts to improve end-of-life nursing care.