Nursing Students Have Knowledge Gaps on End-of-Life Communication
Burnout is causing many nurses to consider leaving the field of nursing altogether, as evidenced by multiple recent studies.1-3 Rebecca Dias, MSN, FNP-BC, noted that lack of preparation for end-of-life care was the source of considerable stress for nursing students. “I have seen that nurses often express discomfort with providing end-of-life care. Student nurses tend to be strongly impacted by providing this care during clinical rotations,” says Dias, an instructor of nursing at University of Maine at Fort Kent.
Dias and colleagues conducted a study to determine if improving nurses’ comfort with end-of-life care could lessen the overall stress nurses experienced and, in the bigger picture, if it could mitigate the nursing shortage. Five nursing students participated in a simulation of a telehealth patient encounter.4 Playing the role of a hospice nurse, the students assessed the patient’s current status and needs and provided guidance to the patient and caregiver about the progression of the patient’s condition and what to expect going forward.
Overall, the study participants were comfortable with the clinical aspects of end-of-life care — medication usage, physical assessments, and physiologic changes. However, the nursing students struggled with communication skills. In particular, nursing students had difficulty interacting with caregivers. One participant stated, “The communication aspect was worrisome for me and definitely what I felt least ready for.” Another stated, “This experience made me realize how many unanswered questions that patients and families often have and the importance of that information.”
In addition, the nursing students felt more comfortable with end-of-life communication after the simulation. One acknowledged that the simulation “took me out of my comfort zone, which always makes you learn in the long run, so I am thankful for that.” Interacting with emotional patients and family was particularly challenging for the students. Students noted that the simulation was helpful in this regard specifically because it involved interacting with actual people instead of manikins. “This can more closely replicate an actual clinical encounter, and allows the student to learn the limits of their knowledge in a safe environment,” says Dias.
Undergraduate nursing education needs to offer students more opportunities to practice communicating with patients and caregivers in end-of-life cases, the study’s findings suggest. “This will help alleviate the anxiety and stress that students feel, leading them to more effectively communicate sensitive information with patients and their loved ones,” concludes Dias.
- Christianson J, Johnson N, Nelson A, Singh M. Work-related burnout, compassion fatigue, and nurse intention to leave the profession during COVID-19. Nurse Lead 2023;21:244-251.
- Rotenstein LS, Brown R, Sinsky C, Linzer M. The association of work overload with burnout and intent to leave the job across the healthcare workforce during COVID-19. J Gen Intern Med 2023;38:1920-1927.
- Maunder RG, Heeney ND, Greenberg RA, et al. The relationship between moral distress, burnout, and considering leaving a hospital job during the COVID-19 pandemic: A longitudinal survey. BMC Nurs 2023;22:243.
- Dias R, Robinson K, Poirier P. The effect of simulation on nursing student perceptions of readiness to provide end-of-life care. J Hosp Palliat Nurs 2023;25:E116-E123.
Burnout is causing many nurses to consider leaving the field of nursing altogether, as evidenced by multiple recent studies. Lack of preparation for end-of-life care is a source of considerable stress for nursing students.
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