Palliative Care Nursing Education Initiative

Topic: Education

There is a national shortage of palliative care specialists and mounting evidence that patients who receive palliative care live longer with better quality of life. At Virginia Mason Medical Center we also were experiencing a high demand for palliative care specialists. We also found that many of the requests were for generalized palliative care, which nurses can deliver with the right knowledge and skills.

Once the need for more generalized palliative care was identified, the current knowledge of our staff was assessed using the validated tool, The Palliative Care/End-of-life Professional Caregiver Survey (EPCS).

The focus of this initiative was to enhance palliative care knowledge and practices of Virginia Mason Registered Nurses to meet the needs of the patients and their families at the point of care by their familiar care providers, nurses.

The goal of the initiative was to provide nurses with the knowledge, skills and tools in order to apply general palliative care principles in their nursing practices.

The City of Hope’s End of Life Education Consortium (ELNEC) was used to train 3 cohorts of nurses. A total of 46 RNs were successfully trained

Each cohort consisted of ambulatory and inpatient RNs. Cohort one was the Cardiology cohort, nurses from inpatient telemetry units and outpatient cardiology care managers were involved.  Cohort two was comprised of internal medicine outpatient clinics, inpatient medical/surgical units, and Clinical Nurse Leaders from inpatient units. The third cohort was our oncology service line including RNs from outpatient infusion, oncology clinic and inpatient oncology.

Having cohorts from across our healthcare system optimized care transitions throughout the continuum of care to help support patients with serious conditions. It also provided cohesiveness and understanding between the inpatient and outpatient RNs.

Course time spent in the classroom consisted of didactic, hands-on learning, and role playing. Two hour learning seminars were held between and after the 8hr learning sessions which provided follow up.

In addition to the classroom sessions, there was also a "walk in their shoes" experience with Virginia Mason’s Palliative Care Team. The Ns were given an opportunity to shadow with a member of the Palliative Care Team.. This allowed the RN to see the team in action, use the skills learned in the seminar, and be provided with just in time feedback from the Palliative Care team. This experience was monumental to the RNs in and their practice.

The evaluation tool used post the completion of their learnings reflected the RN’s high satisfaction with the ELNEC training as well as satisfaction with their job.  During the learning seminars the RNs revealed real case scenarios that highlighted their development and competency in providing general palliative care.


  • Journal of Palliative Medicine, Vol 15 (4), 2012:427-431
  • Clinical Practice Guidelines 3rd edition pdf
  • Wittenburg-Lyles el al. (2013) Communication in Palliative Nursing, New York, Oxford University


  • Edit Shalom, BSN-BC
  • RN Educator
  • Virginia Mason Medical Center
  • 1100 9th Ave, Mail Stop G2-EDU
  • Seattle, WA 98115
  • (206) 341-0636


  • Deborah Kelly , MN, RN
  • Edit Shalom, BSN-BC
  • Nancy Westvang, MS, RN

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