Promoting Excellence : A Position Statement from American Nursing Leaders : Recommendations

We firmly believe that Advanced Practice Nurses represent a valuable resource in national efforts to improve care and quality of life for Americans and their families living with advanced, life-limiting illness.

We call on leaders in the clinical professions, nursing educators, health service providers, health care payers, and public policy advocates to take the following actions:

  1. PROFESSIONAL ASSOCIATIONS in nursing, medicine, hospice and palliative care are called to engage in dialogue about the APN role and opportunities and strategies to advance it in palliative care.

  2. NURSING EDUCATORS must become knowledgeable about palliative care, and
    • Develop continuing education to prepare existing APNs in palliative care competencies for the care of patients and families experiencing a life-limiting illness;
    • Integrate core palliative care competencies into the education of all APN students, particularly those who will care for patients and families experiencing a lifelimiting illness; and
    • Develop clinical tracks for APN students who intend to specialize in palliative care.

  3. PAYERS OF HEALTH SERVICES are called on to recognize the specialty of palliative care and provide APNs with adequate and consistent compensation that is commensurate with APN scope of practice, authority and responsibility, regardless of practice setting or specialty and subspecialty.

  4. THE NATIONAL COUNCIL OF STATE BOARDS OF NURSING and individual state boards of nursing are called on to work collaboratively to consistently recognize APN scopes of practice and privileges regardless of specialty and subspecialty.

  5. HEALTH SYSTEMS OR HEALTH SERVICE PROVIDERS are asked to develop or expand practice opportunities for APNs in all settings that care for patients who may experience a life-limiting illness.

  6. ADVANCED PRACTICE NURSES who practice in palliative care are called on to document and disseminate the outcomes of their practice experience and roles, engage in interdisciplinary research, and translate research findings into practice.

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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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