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Supporting students

Explore the issues nursing students face in providing end-of-life care. Learn teaching strategies to address these challenges and societal influences. Discover effective support techniques and coping mechanisms. Enhance student learning through practical experiences and communication skills training.

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Supporting students

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  1. Supporting students May 7 2008

  2. Questions/ Questions • What situations/issues do students face in caring for patients and families at the end of life? • Quels sont les défis/difficultés que les étudiants peuvent rencontrer lors des soins du client et de leur famille en fin de vie ? • What teaching strategies or supports have you used to address these situations? • Quelles stratégies d’enseignement ou de soutien avez-vous utilisées pour ces situations ?

  3. Issues • Many nurses and nursing students have difficulty dealing with death (Payne et, al.1998; Servaty et al., 1996; Waltman & Zimmerman 1992; Brockopp et al., 1991; Thompson, 1985 in Mallory 2003) • Students reported “true feeling of inadequacy” in their ability to provide both patients and families with emotional support at the end-of-life. Coming from a Canadian study to uncover students’ concerns about caring for the dying.(Milton, 1984).

  4. ISSUES • Feelings of personal inadequacy result in death anxiety (Beck,1997) • Initial feelings of hesitancy and discomfort (Allchin,2006) • Negative attitudes, stress, avoidance, sadness,non open communication, stereotyped attitudes (Allchin,2006)

  5. Issues • Anxiety in 1st year nursing students (Cooper, 2005) • Coping with the physical suffering of patients • Not knowing what to do or say • The severing of the relationship with the patient • The type of death • Cardiopulmonary resuscitation • Postmortem care • Use of coping mechanisms

  6. Professional and Societal Influences (Quint, 68) • Value of recovery care • Personal gratification and professional rewards working with patients who are getting well • Expectations from the public: high esteem for the life-saving capabilities of nurses and doctors • Our society has little contact with those who are dying (young people in urban, industrialized societies)

  7. Strategies • Providing nursing students with opportunities to experience caring for dying patients decrease their death anxiety (Beck, 1997) • Include EOLC content in nursing curricula (theory and clinical) (Brajtman & al,2007; Mallory,2003) • Prepare students by providing a detailed patient report (Mallory,2006) • Introduce student to patient and family and explain the student’s role in caring for the patient (Mallory,2006)

  8. Strategies • Provide students with suggestions of ways to interact with patient and family • Suggest palliative measures which student can initiate • Emphasize the importance for student nurses of the power of silence & presence • “I really enjoyed talking with families and the patient…. I learned that you don’t have to speak all the time and that a person’s support is sometimes the only thing needed.” ( Kwekkeboom & al,2005). • Provide opportunity to role play difficult conversations

  9. Strategies (Mallory,2006) • Encourage students to identify any additional patient needs and suggest further interventions or consults • Provide follow-up de-briefing, and give feed-back to student • Allow students to discuss their thoughts and feelings about the experience • Encourage self-reflection

  10. Strategies • Small group discussions/clinical conferences built upon ‘teachable moments’ have shown value (Hsu,2007; Kwekkeboom et al, 2005; Birkholtz et al, 2004; Mallory,2003) : • 1) video trigger tapes • 2) use of narrative • 3) reflection/reaction papers • 4) use of art, poetry, music(Johnson, 2005)

  11. Educators can create the atmosphere • Learners are encouraged to evaluate their beliefs and views on the subject by using self-reflection. (Mallory , 2003) • Be aware of your own personal feelings related to death and dying. (Mallory , 2006)

  12. References • Allchin, L. (2006). Caring for the dying: Nursing student perspectives. Journal of Hospice and Palliative Nursing, 8(2), 112-117. • Beck, C.T. (1997). Nursing students' experiences caring for dying patients./ Nurs Educ.;36(9):408-415. • Birkholz, G., Clements, P. T., Cox, R., & Gaume, A. (2004). Students’ self-identified learning needs: A case study of baccalaureate students designing their own death and dying course curriculum. Journal of Nursing Education, 43(1), 36-39. • Brajman, S. , Fothergill-Boubonnais, F., Casey, A., Alain, D. & Fiset, V. (2007). Providing direction for change: A survey of Canadian Baccalaureate Nursing students’ learning needs in end-of life Care. International Journal of Palliative Nursing, 13(5), 213-221. • Cooper, J. & Barnett, M. (2005). Aspects of caring for dying patients which cause anxiety to first year student nurses. International Journal of Palliative Nursing, 11 (8), 423-430. • Ferrell, B, Virani, R., & Grant, M. (1999). Analysis of end-of-life content in nursing textbooks. Oncology Nursing Forum, 26, 869-876.

  13. References • Hsu, L. (2007).Conducting clinical post-conference in clinical teaching: A qualitative study. Journal of Clinical Nursing. 16 (8), 1525-1533. • Johnson, A., Jackson, D. (2005). Using the arts and humanities to support learning about loss, suffering and death. International Journal of Palliative Nursing, 11(8), 438-443. • Kirrchhoff.K. T., Beckstrand, R. L., & Anumandla, P.R. (2003). Analysis of end-of-life content in critical care nursing textbooks. Journal of Professional Nursing, 19 (6), 372-381. • Kwekkeboom, K.L., Vahl, C., & Eland, J. (2005). Companionship and education: A nursing student experience in palliative care. Journal of Nursing Education, 44 (4), 169-176. • Mallory, J. L., & Allen, C. L. (2006). Care of the dying: A positive nursing student experience. MEDSURG Nursing, 15(4), 217-222.Mallory, J.L. • Mallory, J. L. (2003). The impact of a palliative care educational component on attitudes toward care of the dying in undergraduate nursing students. Journal of professional Nursing, 19 (5), 305-312.

  14. References • Milton, I.C. (1984). Concerns of final year baccalaureate students about nursing dying patients. Nursing Eduction.;32(7):298-301. • Quint, J, C. (1968). Preparing nurses to care for the fatally ill. International Journal of Nursing studies, 5 (1), 53-61. • Thompson, G. T. (2005). Effects of end-of-life education on baccalaureate nursing students. AORN Journal, 82 (3), 434-440. • Walsh, S. M., & Hogan, N. S. (2003). Oncology nursing education: Nursing students’ commitment of “presence” with the dying patient and the family. Nursing Education Perspectives, 24 (2), 86-90.

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