Strengthening nursing education to improve end-of-life care.

The survey results provide future direction for nursing education. Results indicate an awareness in the nursing profession of the need for improved EOL care and identification of resources to achieve that goal. Many activities have been initiated within the nursing community, and the results of this project hopefully will stimulate additional activities. The imperative for improved EOL care will escalate in the future as our elderly population grows and a burdened health care system confronts the costs of chronic and terminal illness. Palliative care, which has traditionally been limited to hospice programs, must extend to other settings and be incorporated into the trajectory of care. The IOM report and other palliative care literature asserts that improved care for the dying will necessitate change at many levels. Patients and the general public must be educated to expect a higher standard of care at the EOL. Health care system changes are needed to improve access to care and to eliminate barriers such as regulatory constraints on prescribing opioids. However, central to all health care reform is the need for educated professionals to direct this change. As professionals dedicated to patient comfort and quality of life--even at the EOL, nurses should begin the revolution in EOL care by attending to the education of nurses.