The ELNEC Toolbox

While not all nurses expect to deal with end-of-life issues, Rita Moldovan, DNP, RN, sees value in providing training in palliative care to everyone in the profession.  Moldovan, a Clinical Nurse Specialist who specializes in Palliative Care in Johns Hopkins Department of Medicine Nursing,  reports that the ELNEC (End of Life Nursing Education Consortium) certification course offered every year at Johns Hopkins has been a very empowering experience for the more than 300 nurses who have taken it so far.

The two-day course is divided into eight modules, each taught by a subject matter expert, covering topics such as ethics, spirituality, cultural issues, and last hours. “It gave us a framework within which to teach,” says Lynn Billing RN, CHPN, who, like Moldovan, teaches the course once or twice a year. “That’s been very valuable, but we as teachers have been able to adapt it to the needs of the participants based on their feedback. It’s become very experiential and interactive as a result.”

What does the course have to offer nurses for use in their daily work, regardless of whether they expect to encounter end-of-life issues?

  • Improved communication skills to help patients make sense of bewildering or overwhelming options
  • An approach to looking beyond the immediate situation to help the patient make the best choices for the long term
  • Skills for supporting and working with the patient’s family, including sensitivity to cultural beliefs and prohibitions
  • Opportunity for self-reflection and sharing experiences with colleagues; Moldovan notes that it can be very healing for the participants to hear that they are not alone
  • Understanding how to weigh the burden of an intervention against the benefits
  • Additional tools for managing patient care situations and working with an interdisciplinary team to provide the best possible care
  • Skills for addressing future care planning
  • Best practices in symptom management
  • Techniques for learning how to address the patient-family unit as a whole, asking the right questions to uncover unspoken motivations and fears that may be impacting patient choices
  • Increased confidence in working with patients and making recommendations for their care

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