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Empowering Nursing Assistants to Improve End-of-Life Care

Wholihan, Dorothy DNP, ACHPN; Anderson, Robyn MSN, ACHPN

Journal of Hospice & Palliative Nursing: February 2013 - Volume 15 - Issue 1 - p 24–32
doi: 10.1097/NJH.0b013e31825f345b
Feature Articles

Nursing assistants are integral to palliative care and are often the most deeply involved and consistent care providers to dying patients. Yet the contributions of nursing assistants are often unrecognized and underappreciated. They are frequently marginalized when it comes to professional education activities, particularly in the acute care setting. This article describes an educational initiative based on the Hospice and Palliative Nursing Association nursing assistant core curriculum. A daylong educational intervention was provided to a voluntary convenience sample of nursing assistants from a variety of inpatient units. Presurveys and postsurveys about knowledge, attitudes, and awareness of ethical issues were administered to those attending the class, as well as a control group of nursing assistants. The results of this pilot study showed that a daylong conference on end-of-life care was associated with improved measures of knowledge, attitudes about care of the dying, and awareness of ethical issues. Interesting points of discussion concerned the points of tension identified by nursing assistants in the care of dying patients, the need for ongoing support for these staff members, and the practical issues of how to best educate and integrate nursing assistants into the palliative care team.

Dorothy Wholihan, DNP, ACHPN, is coordinator, Palliative Care NP Specialty Program, NYU College of Nursing, New York.

Robyn Anderson, MSN, ACHPN, is palliative care coordinator, JJ Peters VA Medical Center, Bronx, New York.

Address correspondence to Dorothy Wholihan, DNP, ACHPN, NYU College of Nursing, 726 Broadway, 10th Floor, New York, NY 10003 (

No funding was received for this work.

The authors have no conflict of interest to disclose.

© 2013 The Hospice and Palliative Nurses Association