Concerns about the care provided to people dying from life-threatening illness have prompted a number of international reforms to improve the quality of palliative and end-of-life (EOL) care. The majority of this care is provided by nurses. They spend more time with dying patients than any other health professionals and therefore, need specific clinical skills and knowledge. Palliative and EOL care education is increasingly being positioned as a specialism, available only to a small number of registered nurses as part of continuing professional development. However, increasing numbers of patients with life-threatening illness are being treated in non-specialist settings by nurses with a generalist education. Furthermore, undergraduate nurse education has traditionally had a limited focus on palliative and EOL care, hence claims that undergraduate nursing curricula are inadequate. Drawing on an international literature, this review explores the evidence about the adequacy of undergraduate curricula in this area. It considers the extent to which palliative and EOL curriculum is included in undergraduate nurse education and draws upon evidence from students and registered nurses, who as consumers of education, report feeling unprepared to care for and communicate with, dying patients.
Addington-HallJ. & HigginsonI. J. (Eds.). (2001). Palliative care for non-cancer patients, Oxford: Oxford University Press.
2.
AdriaansenM. & van AchterbergT. (2008). The content and affects of palliative care courses for nurses: A literature review. International Journal of Nursing Studies, 45, 471–485.
3.
AllchinL. (2006). Caring for the dying: Nursing student perspectives. Journal of Hospice and Palliative Nursing, 8(2), 112–117.
4.
AulinoF. & FoleyK. (2001). Professional education in end of life care: A US perspective. Journal of the Royal Society of Medicine, 94, 472–476.
5.
ArberA. (2001). Student nurses' knowledge of palliative care: Evaluating an education module. International Journal of Palliative Nursing, 7(12), 597–603.
6.
BarrereC. C.DurkinA. & LaCoursiereS. (2008). The influence of end-of-life education on attitudes of nursing students. International Journal of Nursing Education Scholarship, 5, article 11.
7.
BeckC. T. (1997). Nursing students' experiences of caring for dying patients. Journal of Nursing Education, 36, 408–415.
8.
BlumC. A. (2006). “Til death do us part?” the nurses role in the care of the dead: A historical perspective: 1850–2004. Geriatric Nursing, 27(1), 58–63.
9.
BrajtmanS.HiguchiK. & MurrayM. A. (2009). Developing meaningful learning experiences in palliative care nursing education. International Journal of Palliative Nursing, 15(7), 327–331.
10.
BruecknerT.SchumacherM. & SchneiderN. (2009). Palliative care for older people; exploring the views of doctors and nurses from different fields in Germany. BMC Palliative Care, 8(7). doi: 10.1186/1472-684x-8-7
11.
BurtJ.ShipmanC.Addington-HallJ. & WhiteP. (2008). Nursing the dying within a generalist caseload: A focus group study of district nurses. International Journal of Nursing Studies, 45, 1470–1478.
12.
BushT. (2012). Palliative care education: Does it influence future practice. Journal of Palliative Care & Medicine, 2(4), 1–4.
13.
CavayeJ. (2009). The first death: A student's experience. In EarleS.BartholomewC. & KormaromyC. (Eds.), Making sense of death, dying and bereavement: An anthology (pp. 145–147). London, UK: Sage Publications.
14.
CavayeJ. & WattsJ. H. (2014). An integrated literature review of death education in pre-registration nursing curricula: Key themes. International Journal of Palliative Care, published online doi.org/10.1155/2013/564619.
15.
CentenoC. (2006). EAPC Task Force on the development of palliative care in Europe. European Journal of Palliative Care, 13, 149–151.
16.
ChanM. M. H.SallnowL. & MurrayS. A. (2014). Community initiatives foster health-promoting palliative care in Singapore. European Journal of Palliative Care, 21(1), 27–29.
17.
CooperH. M. (1998). Synthesizing research: A guide for literature reviews, Thousand Oaks, CA: Sage Publications.
18.
CuiJ.ShenF.MaX. & ZhaoJ. (2011). What do nurses want to learn from death education? A survey of their needs. Oncology Nursing Forum, 38(6), 402–408.
19.
CunninghamS. M.CoppG.CollinsB. & BaterM. (2006). ‘Pre-registration nursing students' experience of caring for cancer patients. European Journal of Oncology Nursing, 10(1), 59–67.
20.
DeffnerJ & BellS. (2005). Nurses' death anxiety, comfort level during communication with patients and families regarding death, and exposure to communication education: A quantitative study. Journal for Nurses in Staff Development, 21, 19–23.
21.
Department of Health. (2008). End of life strategy: Promoting high quality care for all adults at the end of life. London, UK: The Stationery Office.
22.
De VliegerM.GorchsN.LarkinP. & PorchetF. (2004). A guide for the development of palliative nurse education in Europe. Milan, Italy: European Association for Palliative Care.
23.
DickinsonG. E. (2007). End-of-life and palliative care issues in medical and nursing schools in the United States. Death Studies, 31(8), 713–726.
24.
DickinsonG. E. (2012). End of life issues in selected US professional schools. Illness Crisis and Loss, 20(1), 19–33.
25.
DickinsonG. E.ClarkD. & SqueM. (2008). Palliative care and end of life issues in UK pre-registration undergraduate nursing programmes. Nurse Education Today, 28(2), 163–170.
26.
DobbinsE. H. (2011). The impact of end-of-life curriculum content on the attitudes of associate degree nursing students toward death and care of the dying. Teaching and Learning in Nursing, 6, 159–166.
27.
Downe-WamboldtB. & TamlynD. (1997). An international survey of death education trends in faculties of nursing and medicine. Death Studies, 21(2), 177–188.
28.
FerrellB. R.ViraniR. & GrantM. (1999). Analysis of end-of-life content in nursing textbooks. Oncology Nursing Forum, 26(5), 869–876.
FerrellB. R.ViraniR. & GrantM. (2005). Evaluation of the end-of-life nursing education consortium undergraduate faculty training program. Journal of Palliative Medicine, 8(1), 107–114.
31.
FrommeltK. H. (1991). The effects of death education on nurses attitudes towards caring for terminally ill persons and their families. The American Journal of Hospice and Palliative Care, 7(5), 37–43.
32.
GibbonsC.DempsterM. & MoutrayM. (2011). Stress coping and satisfaction in nursing students. Journal of Advanced Nursing, 67(3), 621–632.
33.
GomesB. & HigginsonI. (2004). Home or hospital: Choices at the end of life. Journal of Royal Society of Medicine, 97(9), 413–414.
34.
GomesB. & HigginsonI. (2008). Where people die (1974–2030): Past trends, futures projections and implications for care. Palliative Medicine, 22, 33–41.
35.
Health Canada. (2007). Canadian strategy on palliative and end of life care. Final Report.
36.
HirschG. (2009). SFAP: France is witnessing major developments in palliative care. European Journal of Palliative Care, 16(2), 100–101.
37.
HopkinsonJ. B.HalletC. E. & LukerK. A. (2005). Everyday death: How do nurses cope with caring for dying people in hospital?International Journal of Nursing Studies, 42(2), 125–133.
38.
Institute for Clinical Systems Improvement. (2009). Health care guidelines: Palliative care. Minnesota.
39.
Irish Hospice Foundation. (2009). Hospice friendly hospitals: Draft quality standards for end of life care in hospitals. Dublin, Ireland.
40.
JohnsonA.ChangE. & O'BrienL. (2009). Nursing the dying: A descriptive survey of Australian undergraduate nursing curricula. International Journal of Nursing Practice, 15(5), 417–425.
41.
JohnstonB. & SmithL. (2006). Nurses' and patients' perceptions of expert palliative nursing care. Journal of Advanced Nursing, 54(6), 700–709.
42.
KurzJ. & HayesE. (2006). End of life issues action: Impact of education. International Journal of Nurse Education Scholarship, 3, 1–13.
43.
LangeM.ThomB. & KlineN. (2008). Assessing nurses' attitudes towards death and caring for dying patients in a comprehensive cancer centre. Oncology Nursing Forum, 35, 955–959.
44.
LeightonK. & DubasJ. (2009). Simulated death: An innovative approach to teaching end-of-life care. Clinical Simulation in Nursing, 5(6), e223–e230.
45.
LemingM. R. & DickinsonG. E. (2007). Understanding dying, death and bereavement(6th ed.), Belmont, CA: Thomson Higher Education.
46.
Lloyd-WilliamsM. & FieldD. (2002). Are undergraduate nurses taught palliative care during their training?Nurse Education Today, 22, 589–592.
47.
LoftusL. (1998). Student nurses' lived experiences of the sudden death of their patients. Journal of Advanced Nursing, 27(3), 641–648.
48.
LynchT.ClarkD. & CentenoC. (2010). Barriers to the development of palliative care in Europe. Palliative Medicine, 24(1), 812–819.
49.
MalloryJ. (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), 303–312.
50.
MalloyP.FerrellB.VirianiR.UnmanG.RhomeA. & WhitlachB. (2006). Evaluation at end of life nursing education for continuing education and clinical staff development educators. Journal for Nurses in Staff Development, 22, 31–36.
51.
McGannS. (2013). The production of hospice space. Farnham, Surrey: Ashgate.
52.
MooneyD. C. (2005). Tactical reframing to reduce death anxiety in undergraduate nursing students. American Journal of Hospice and Palliative Medicine, 22(6), 427–432.
53.
MuttoE.CantoniM.RabhanslM. & VillarM. (2012). A perspective of end-of-life care education in undergraduate medical and nursing students in Buenos Aires, Argentina. Journal of Palliative Medicine, 15(1), 93–98.
54.
O'ConnorS. J. & FitzsimmonsD. (2005). Embedding cancer care within pre-registration nurse education programmes: Policy, practice and opportunities for change. European Journal of Oncology Nursing, 9(4), 341–350.
55.
PaiceJ. A.FerrellB. R.CoyleN.CoyneP. & CallawayM. (2008). Global efforts to improve palliative care: The international end-of-life nursing education consortium training programme. Journal of Advanced Nursing, 61(2), 173–180.
56.
Palliative Care Australia. (2009). National report on palliative care in Australia. Canberra, Australia.
57.
PetersonJ.JohnsonM.ScherrC. & HalvorsenB. (2013). Is the classroom experience enough? Nurses' feelings about their death and dying education. Journal of Communication in Healthcare, 6(2), 100–105.
58.
PfundR.DawsonP.FrancisR. & ReesB. (2004). Learning how to handle emotionally challenging situations: The context of effective reflection. Nurse Education in Practice, 4(2), 107–113.
59.
PhillipsJ.PizaM. & InghamJ. (2012). Continuing professional development programmes for rural nurses involved in palliative care delivery: An integrative review. Nurse Education Today, 32, 385–392.
60.
QuintJ. C. (1967). The nurse and the dying patient. New York, NY: Macmillan.
61.
RadbruchL.de LimaL.LohmannD.GwytherE. & PayneS. (2012). The Prague Charter: Urging governments to relieve suffering and ensuring the right to palliative care. Palliative Medicine, 27(2), 101–102.
62.
RamjanJ. M.CostaC. M.HickmanL. D.KearnsM. & PhillipsJ. L. (2010). Integrating palliative care content into a new undergraduate nursing curriculum: The University of Notre Dame, Australia-Sydney experience. Collegian, 17(2), 85–91.
63.
RonsenA. & HanssenI. (2009). Communication in palliative care: Philosophy, teaching approaches and evaluation of an educational program for nurses. Nurse Education Today, 29, 791–795.
SchlairetM. (2009). End of life nursing care: State wide survey of nurses' education needs and effects of education. Journal of Professional Nursing, 25(3), 170–177.
66.
SchneidermanL. J. & JeckerN. S. (2011). Wrong medicine: Doctors, patients and futile treatment(2nd ed.), Baltimore, MD: The Johns Hopkins University Press.
67.
ShipmanJ.BurtJ.ReamE.BeynonT.RichardsonA. & Addington-HallJ. (2008). Improving district nurses knowledge in the principles and practice of palliative care. Journal of Advanced Nursing, 63(5), 494–505.
68.
SkilbeckJ. & PayneS. (2005). End of life care: A discursive analysis of specialist palliative care nursing. Journal of Advanced Nursing, 51(4), 325–334.
69.
TyreeT.LongC. & GreenbergE. (2005). Nurse practitioners and end of life care: Beliefs, practices and perceptions. Journal of Hospice and Palliative Nursing, 7(1), 45–51.
70.
WallaceM.GrossmanS.CampbellS.RobertT.LangeJ. & SheaJ. (2009). Integration of end-of-life care content in undergraduate nursing curricula: Student knowledge and perceptions. Journal of Professional Nursing, 25(1), 50–56.
71.
WalshS. & HoganN. (2003). Oncology nursing education: Nursing students' commitment of “Presence” with the dying patient and the family. Nursing Education Perspectives, 24(2), 86–90.
72.
WallerstedtB. & AndershedB. (2007). Caring for dying patients outside specialist palliative care settings: Experiences from a nursing perspective. Scandinavian Journal of Caring Science, 21, 32–40.
73.
WassH. (2004). A perspective on the current state of death education. Death Studies, 28, 289–308.
74.
WattsJ. H. (2010). Death dying and bereavement: Issues for practice. Edinburgh: Dunedin Academic Press.
75.
WeigalC.ParkerG. & FanningL. (2007). Apprehension amongst hospital nurses providing end of life care. Journal of Hospice and Palliative Nursing, 9(2), 86–91.
76.
WellsM. J.WilkieD. J.BrownM.CorlessI. B.JudgeM. K. M. & ShannonS. E. (2003). Technology survey of nursing programmes: Implications for electronic end of life teaching tool development. Computers, Informatics, Nursing, 21(1), 29–35.
77.
WesselE. & RutledgeD. (2005). Home care and hospice nurses' attitudes towards death and caring for the dying. Journal of Hospice and Palliative Nursing, 7(4), 212–218.
78.
WhiteK. R.CoyneP. J. & PatelU. B. (2001). Are nurses adequately prepared for end of life care?Journal of Nursing Scholarship, 33, 147–151.
79.
WhittemoreR. & KnaflK. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546–553.
80.
WoodsS.BeaverK. & LukerK. (2000). Users views of palliative care services: Ethical implications. Nursing Ethics, 7(4), 314–326.
81.
WongF. & LeeW. (2000). A phenomenological study of early nursing experiences in Hong Kong. Journal of Advanced Nursing, 31(6), 1509–1517.
82.
World Health Organization (WHO). (2002). National cancer control programmes: Policies and guidance. Geneva, Switzerland.
83.
World Health Organization (WHO). (2012). World Health Statistics. Geneva, Switzerland.
