Course Code: REL-PAC-ELNEC-CMFINHRS
Hours: 1.75
Type: Online Course
Content Expiration Date: 12/31/2029
Learning Objectives:
Identify five physical signs and symptoms of the dying process and the important areas of assessment.
Recognize the important physical, psychological, social, cultural, and spiritual aspects of care of the patient nearing death and their family caregivers.
Define the role of the nurse during the dying process.
Outline:
Section 1: Preparing for a Good Death
A Good Death
Types of Death and Setting of Care
Witnessing a Good Death
Preparing for Death
The Nurse, Dying, and Death
Reflection on a Recent Patient Death
Open, Honest Communication
Guidelines
Case Study
Importance of Being Honest
Dying as an Individualized, Personal Experience
Culture
Questions to Ask
Decision-Making for Life-Sustaining Treatments
Autonomy
Beneficence
Nonmaleficence
Medically Administered Nutrition and Hydration
Arguments for Medically Administered Nutrition and Hydration
Arguments Against Medically Administered Nutrition and Hydration
Resuscitation
Discontinuation of Cardiac Devices and Treatment
CRT-P Devices
ICDs and CRT-D
ECMO and LVAD
Discontinuation of Inotropes
Discontinuation of Mechanical Ventilation
Discontinuation of Dialysis
Pharmacological Symptom Management
Organ and Tissue Donation
Requests for Medical Aid in Dying
Spiritual and Cultural Considerations
Meet Gabriela Martinez
Stop and Consider
Stop and Consider
Review
Key Takeaways
Section 2: Care at End of Life
Signs and Symptoms
Common Symptoms at End of Life
Common Symptoms at End of Life
Dyspnea
Pain
Noisy Breathing/Respiratory Congestion
Delirium
Fever
Bowel Changes
Incontinence
Decreased Intake
Pain Management During the Final Hours
Assessment
Pharmacological Management
Clinical Considerations
Myoclonus
Palliative Sedation: Sedation for Uncontrolled Symptoms
Opioids
Benzodiazepines
Ketamine
Propofol
Caregiver Support
The Death Vigil
Gabriela at Home
Stop and Consider
Stop and Consider
Stop and Consider
Review
Key Takeaways
Section 3: Bereavement Care
Care Following Death
Care and Respect of the Body
The Pause
Bereavement Support
Stop and Consider
Remember the Children
Care Principles
Gabriala’s Death
Stop and Consider
Stop and Consider
Review
Key Takeaways
Section 4: Conclusion
Course Summary
Course Information
Course Contributors
Resources
References
Subject Matter Expert: 2026 ELNEC Core Series
The content for this course was written by The ELNEC Project Team.
The ELNEC Project, which began in 2000, is a collaboration between City of Hope, Duarte, CA and the American Association of Colleges of Nursing (AACN), Washington, DC. For more information about ELNEC, go to www.aacnnursing.org/ELNEC
The content for this course was revised by Constance Dahlin, MSN, ANP-BC, ACHPN®, FPCN, FAAN.
Constance Dahlin has focused her career within hospice and palliative care. Connie serves as national faculty for the End-of-Life Nursing Education Consortium (ELNEC). She has practiced palliative care across the health continuum: home, clinic, long-term care, rehabilitation, and acute care settings. She has administered hospice, home health, and palliative care programs. She has created education for program development, academic curricula, and interprofessional team education.
Currently, Ms. Dahlin is a palliative nurse practitioner at MGB Salem Hospital. She is faculty at University of Maryland Baltimore PhD, MS, and Graduate Certificate in Palliative Care. She is a consultant and senior nurse advisor to the Center to Advance Palliative Care (CAPC) with a focus on community-based care and education. She is co-director of the Palliative APP Externship at the Medical University of South Carolina. She serves on the American Hospital Association Circle of Life Award Committee, the Massachusetts Network for Community-Based Care, and the Massachusetts Comprehensive Cancer Steering Committee.
Ms. Dahlin has authored many peer-reviewed articles, chapters, and curricula. She has presented nationally and internationally. Ms. Dahlin is co-editor of the Oxford University Press Advanced Practice Palliative Nursing 1st and 2nd editions. She edited and authored four editions of the Palliative Nursing: Scope and Standards and three editions of the Competencies for the Palliative and Hospice RN, and APRN. She wrote the Hospice and Palliative APRN Professional Practice Guide and A Primer of Reimbursement, Billing, and Coding: Essential Information for the Hospice and Palliative APRN. She referenced the 2004 first education of the National Consensus Project’s Clinical Practice Guidelines for Palliative Care and edited the 2009 and 2013 editions.
Ms. Dahlin is a Fellow of Hospice and Palliative Nursing, a Fellow of the American Academy of Nursing, a 2005 Certified ACHPN APRN of the year, a 2016 Sojourns Cambia Health Foundation Sojourns Leadership Scholar Award Recipient, a 2018 American Academy of Hospice and Palliative Medicine Visionary in Hospice and Palliative Medicine, the 2020 Hospice and Palliative Nursing Association Distinguished Practice Award and the 2021 University of Maryland Baltimore Program in Palliative Care Teacher of the Year. She completed her MSN in oncology nursing and her post-masters in adult primary care at the MGH Institute of Health Professions.
Target Audience:
The target audience for this course is: Advanced Practice Nurses; Nursing Personnel; in the following settings: Hospice.
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All courses offered by Relias Learning, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.