Promoting Excellence : Graduate Education In Palliative Care

Palliative Care Program
Ursuline College
The Breen School of Nursing
Pepper Pike, Ohio

Denice Kopcha Sheehan, RN, MSN

Denice Kopcha Sheehan Denice Sheehan, a clinical nurse specialist, coordinates the palliative care track in the master of science in nursing program at The Breen School of Nursing at Ursuline College in Pepper Pike, Ohio. This graduate program is the first in the United States to prepare clinical nurse specialists in palliative care. The first course was offered during the summer of 1997.

Sheehan based the Ursuline program on a national and regional needs survey indicating that palliative care nursing experts supported the need for graduate education in palliative care. This support was echoed by Ursuline College nursing alumnae and Cleveland nursing leaders. The program started with nine students and now enrolls 23 in the palliative care track and postmaster’s certificate program.

Building a Partnership
Sheehan, who has extensive clinical experience in oncology and hospice, decided that palliative care needed to be included in the graduate nursing curriculum. “We needed a partnership among students, clinical agencies and faculty,” she explains.

Ursuline students learn three ways: classroom work, interaction with experienced nurses and an open-door faculty policy. “These three elements plus reflection and contemplation are the strengths of our program,” Sheehan explains. “Our educational program is based on values. Students learn about themselves first by looking at their own values. Then they are able to listen and learn about patient values and provide care based on patient and family needs.”

Communication is another program focus. Students learn how to talk with someone who is dying. “Over time,” Sheehan says, “they come to see dying as a potentially rich experience and gain perspective on their own beliefs on the meaning of life and their own direction in life.”

Instruction includes lectures from invited experts and reviews of the current literature on best practices. This approach ensures that graduates are familiar with palliative care excellence and are well positioned to contribute to the palliative care body of knowledge. Each of the clinical nurse specialist students also completes a practicum. Many spend hours at the Cleveland Clinic’s Harry R. Horvitz Center for Palliative Medicine where they work with the inpatient and outpatient clinical teams. “They are very involved and part of the interdisciplinary team,” Sheehan explains. Students often spend time at the Hospice of the Western Reserve’s Hospice House where they work with advanced practice palliative care nurses, physicians and other providers. Students also work at a variety of other clinical sites, where they learn from professionals who provide grief and bereavement services.

Graduates in Demand
Student and preceptor evaluations are very positive. They are used to reinforce the strengths of the curriculum and seek direction for improvement. Program graduates are in demand by clinical agencies and physicians. “More and more health care professionals nationwide are calling and asking when we will graduate the next class,” Sheehan says. “Of the seven nurses who have graduated so far, four are directly involved in the provision of palliative care.”

Personal Reflection
Prior to establishing this graduate program, Sheehan’s research showed that there were no programs that incorporated palliative care in Ohio or the nation. “I decided that palliative care needed to be included in the curriculum and that it needed to be a partnership between students, clinical agencies and faculty. The education we are providing nursing students is paving the way to improve the ability of medical institutions and communities to care for people with life threatening illnesses and their families.”

Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying persons and their families. Visit for more resources.

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