Promoting Excellence : Conclusion

Future Directions
As these brief profiles reveal, APNs represent a valuable resource for responding to the needs of seriously ill Americans and their families—in a wide variety of geographic and clinical settings and in difficult demographic and sociologic circumstances. All the APNs profiled here are pioneers in overcoming barriers and creating viable and sustainable practices. The clinical expertise and the caring capacity of advanced practice nurses should not go untapped as the number of elderly people grows and the medical system attempts to care for them.

Advanced practice nursing in palliative care offers an exciting career opportunity that can help attract a new generation of men and women to the field of nursing and the proud profession of caring. Currently, however, APNs face challenges in training and licensure, and they may encounter regulatory and reimbursement barriers. With the development of generalist and advanced practice credentialing examinations and the creation of undergraduate and graduate advanced practice programs in palliative care nursing, the time has come for palliative care nursing to be recognized as a specialty in all states. With this recognition, the dream of making effective and compassionate care available for seriously ill and dying patients and families will be one step closer to becoming a reality.


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 PromotingExcellence.org for more resources.

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