ELNEC Undergrad/New Grad Module 5: Loss, Grief, and Bereavement

Outline:
Section 1: Introduction

About This Course

Learning Objectives

Section 2: Overview of Loss, Grief, and Bereavement

Definitions

Loss, Grief, and Bereavement

Nurse’s Role

A Grief and Bereavement Program

Types of Grief

Grief Assessment

The Grief Process

Completion of the Grieving Process

Review

Summary

Section 3: The Effects on Survivors

Factors Affecting Grief

What Do Caregivers Want?

Grief Assessment of Family Members

Listen to Their Story

Everyone Has a Story

Key Points

Memory-Making

Grief Interventions

Words That Are Helpful

Words That Are Not Helpful

Children’s Grief

Bereavement Interventions for Children

Addressing Bereavement

Key Points

Review

Summary

Section 4: The Effects on the Nurse

Cumulative Loss

Moral Distress

Compassion Fatigue

Burnout

Qualities that Protect Nurses from Burnout and Compassion Fatigue

Systems of Support

Self-Care

Key Points

Review

Summary

Section 5: Conclusion

Summary

Course Contributors

References

The content for this course was created or revised by The ELNEC Project Team:

Betty Ferrell, RN, PhD, MA, CHPN, FAAN, FPCN, has been in nursing for 41 years and has focused her clinical expertise and research in pain management, quality of life, and palliative care. Dr. Ferrell is the Director of Nursing Research & Education and a Professor at the City of Hope Medical Center in Duarte, California. She is a Fellow of the American Academy of Nursing and she has over 450 publications in peer-reviewed journals and texts. She is Principal Investigator of a Research Project funded by the National Cancer Institute on "Palliative Care for Patients with Solid Tumors on Phase 1 Clinical Trials" and Principal Investigator of the "End-of-Life Nursing Education Consortium (ELNEC)" project. She directs several other funded projects related to palliative care in cancer centers and QOL issues. Dr. Ferrell is Co-Chairperson of the National Consensus Project for Quality Palliative Care. Dr. Ferrell completed a Master's degree in Theology, Ethics and Culture from Claremont Graduate University in 2007. She has authored eleven books including the Oxford Textbook of Palliative Nursing (5th Edition, 2019) published by Oxford University Press. She is co-author of the text, The Nature of Suffering and the Goals of Nursing published in 2008 by Oxford University Press and Making Health Care Whole: Integrating Spirituality into Patient Care (Templeton Press, 2010). In 2013 Dr. Ferrell was named one of the 30 Visionaries in the field by the American Academy of Hospice and Palliative Medicine.

Rose Virani, BSN, MHA, FPCN is a Senior Research Specialist in the Nursing Research and Education Department at the City of Hope in Duarte, CA. Ms. Virani has worked in various clinical and administrative areas in oncology nursing for over 45 years. She has been the Project Director of ELNEC since its inception 20 years ago, starting with the RWJF supported "End-of-Life Nursing Education Consortium (ELNEC)" conducted from 2000-2005; and presently is the Project Director of all ELNEC projects. As project director, she has participated in the development, coordination and implementation of all ELNEC projects including data collection and follow-up of participants' goals. The data from these projects has resulted in over 40 peer reviewed outcomes publications on the importance and dissemination of palliative care in nursing education--Ms. Virani was the recipient of the 2006 "Excellence in Supportive Care", the 2006 "Mary Nowotny Excellence in Cancer Nursing Education," and the 2009 ONS Pearl Moore, "Making a Difference" Oncology Nursing Society (ONS) awards. Ms. Virani was inducted as a fellow in The Hospice and Palliative Nurses Association in 2009 and is a Florence Wald fellow. In 2016, she was the recipient of the 2016 Hospice and Palliative Nurses Association (HPNA) Distinguished Career Achievement Award. Ms. Virani has coauthored over 60 journal articles and primary author of seven book chapters.

Pam Malloy, MN, RN, FPCN, FAAN is an oncology clinical nurse specialist with over 40 years of experience in clinical oncology and palliative care nursing, staff development, education, program development, and administration. Ms. Malloy has been the national Director and Co-Investigator of the End-of-Life Nursing Education Consortium (ELNEC) Project and Special Advisor on Global Initiatives at the American Association of Colleges of Nursing (AACN) in Washington, DC. She has served as faculty for all the national ELNEC courses and has presented ELNEC in 12 international countries. In addition, she has developed palliative care nursing leadership curricula, taught, and mentored current and future nursing and physician leaders throughout Eastern Europe, Kenya, and Asia. Ms. Malloy directed the California Endowment project for AACN on developing cultural competencies for undergraduate and graduate nursing students. In addition, she collaborated with the US Department of Veterans Affairs to develop the ELNEC-For Veterans curriculum, which was presented to over 500 nurses, representing every VA hospital across the nation. Ms. Malloy is a Florence Wald Fellow, a Fellow in Palliative Care Nursing (FPCN), and the American Academy of Nursing (FAAN). She has written and had published numerous articles in peer-reviewed journals, has written chapters for various textbooks, and consulted on three palliative care grants. She was recently presented with a Lifetime Achievement Award from the MD Anderson Cancer Center.

Polly Mazanec, PhD, AOCN, ACHPN, FPCN, FAAN is an oncology palliative care advanced practice nurse who has been on the ELNEC Faculty since 2001, teaching palliative care nationally and internationally. She has had extensive clinical experience in integrating palliative care into out-patient oncology settings and hospice programs and into nursing education. Dr. Mazanec is a Research Associate Professor at Case Western Reserve University's Frances Payne Bolton School of Nursing (Cleveland, OH) and Co-Investigator on a Web-based intervention for long-distance caregivers of parents with advanced cancer. She is also the Co-Investigator for the ELNEC-Undergraduate and Graduate curriculum, funded by the Cambia Health Foundation. An important part of the ELNEC Undergraduate and Graduate projects has been the development of primary palliative care competencies for undergraduate, Master's and Doctor of Nursing Practice (DNP) students, with online curricula to assist educators in undergraduate and graduate nursing programs prepare nurses to provide palliative care to seriously ill patients and their families. Dr. Mazanec has published and presented in the areas of palliative care in the oncology setting, cultural considerations at end of life, interprofessional education in oncology and palliative care, and caregiving. 

Disclosure: The ELNEC Project Team 2020 has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.