Welcome to the Summer 2012 Edition!
The End-of-Life Nursing Education Consortium (ELNEC) is pleased to bring you ELNEC Connections, a quarterly newsletter to showcase efforts in end-of-life nursing education and practice. This newsletter spotlights project developments and provides resources that may be useful to you as an ELNEC trainer. ELNEC is a national education program to improve end-of-life care by nurses. Today, over 14,100 nurses and other healthcare providers have attended a national train-the-trainer course. ELNEC has been presented in 74 international countries and translated into 6 languages. The project, which began in February 2000, was funded by a major grant from The Robert Wood Johnson Foundation. Additional funding has been received from the National Cancer and Open Society Institutes, and Aetna, Archstone, Oncology Nursing, Bristol-Myers Squibb, Milbank for Rehabilitation, and California Healthcare Foundations, and the US Department of Veterans Affairs. ELNEC is administered through a partnership between the American Association of Colleges of Nursing (AACN) and the City of Hope (COH).
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Four National ELNEC Courses Remaining for 2012
Nurse Educators are encouraged to register for an ELNEC train-the-trainer course and may choose from Core, Pediatric Palliative Care, Geriatric, Critical Care, and ELNEC-For Veterans.  Courses are listed below in the order they will be presented. 
  • ELNEC-Summit:**  August 23 & 24; Washington, DC
  • ELNEC-Summit:**  October 11 & 12; Portland, OR
  • ELNEC-Core:   November 1 & 2; Pittsburgh, PA  (This course will be in collaboration with HPNA)
  • ELNEC-For Veterans:  November 14 & 15; San Antonio, TX (see below for more information on this grant-funded course)
    This 1.5 day course will be held as a pre-conference to the AACN Baccalaureate Conference.  Free registration is available to faculty whose school of nursing is participating in the Joining Forces Campaign.
**ELNEC Summit—ELNEC-Core, Pediatric Palliative Care, Geriatric, and Critical Care train-the-trainer courses are held simultaneously. 
For more information and/or to register, go to www.aacn.nche.edu/elnec/trainings/national.
What’s Up for 2013?
Plans are underway now to finalize the 2013 schedule of ELNEC courses.  Exact dates and locations of courses will be posted on the ELNEC website by August 15, 2012.  Stay tuned!
ELNEC Receives Funding from the Milbank Foundation to Support
ELNEC-For Veterans
The Milbank Foundation for Rehabilitation has awarded grant funding to the ELNEC project to educate nursing faculty on how to provide better palliative care education to students who will in the future be orchestrating care for Veterans with life-threatening illnesses. This work will support the commitment of nursing schools nationwide who are in engaged in the White House’s Joining Forces campaign.
The funding from the Milbank Foundation will provide training, targeted specifically to full-time nursing faculty. The training is scheduled for November 14-15, 2012 in San Antonio, TX and will be offered as a 1 ½ day pre-conference to the American Association of Colleges of Nursing’s (AACN) Baccalaureate Education Conference. Using the grant funding, free registration will be offered to 60 nursing faculty interested in attending the ELNEC-For Veterans course in November. Faculty will be chosen competitively based on their ability to disseminate the curriculum content to other faculty and students within their school. Faculty must be from a nursing school that is supporting the White House’s Joining Forces initiative, a national campaign to improve veteran care by enhancing nursing education.
While many nursing students and faculty have clinical experiences in Veteran’s hospitals, only 4% of veterans actually die in these facilities. Since the other 96% of veteran’s deaths occur in non-VA settings, such as home care, nursing homes, and skilled nursing facilities, it is imperative that all nurses understand the unique needs of this distinct patient population. More than 54,000 American veterans – mostly from World War II and Korea – die each month. Given that the number of Vietnam-era veterans over 65 will continue to grow through 2034, so too will the need for hospice and palliative care.  Nurses will play a major role in this care and must be educated by nursing faculty to provide this care in a compassionate and respectful way.
To find out more about nursing’s commitment to Joining Forces and how your school can pledge support, see http://www.aacn.nche.edu/joining-forces

For further information about this project, including the application, agenda, FAQ, and press release, go to http://www.aacn.nche.edu/elnec.
Top Priority for 2013: Train Advanced Practice Nurses in Palliative Care
Many palliative care teams across the US are led by advanced practice registered nurses (APRNs) These nurses are key team members and exemplify commitment to their varied roles in not only leadership, but practice, education, and research, too. Plans are being made now for the development of a new ELNEC curriculum that will meet the specific needs of APRNs. A group of nationally-known APRNs will meet in Washington, DC in August to collaborate on the curriculum for this unique project.  Two courses are scheduled for 2013: April 4-5 in Anaheim, CA and November 5-6 in Washington, DC. Further information about these courses, including, registration form, agenda, and FAQs will be available on the ELNEC website by October 1, 2012. 
ELNEC-For Public Hospitals Training is Increasing Throughout California
Perhaps one of the most common ways the ELNEC curriculum is used is for new employee orientation. What a great way to say to new staff that the facility is committed to palliative care! ELNEC-For Public Hospitals trainers have taught over 1,200 nurses using Module 1:  Introduction to Palliative Nursing  in nursing orientation since December 2011. In addition, more than 525 nurses have completed modules on pain management and cultural considerations as a yearly, mandatory nursing competency requirement. Each of the 16 public hospital sites that were included in this initiative  has access to ELNEC-For Public Hospitals on the Hospice Education Network (HEN). This allows staff to receive education online and at their convenience. Several new policies and guidelines have been implemented since these trainers attended ELNEC-For Public Hospitals in November 2011. For example: 
  • New policies developed regarding mechanical ventilation withdrawal in various critical care settings (e.g. ICU, NICU, PICU) to reflect compassionate and supportive end-of-life care.
  • Guidelines for palliative care referrals have been accepted by the administration at 6 of the 16 facilities.
  • Interpreter services are receiving ELNEC  training.
  • Monthly professional development opportunities to learn more about such topics as marketing palliative care, self-care, and palliative care in the emergency room.
  • Comfort care orders are being developed in all 16 facilities.
If you currently work in a public hospital and would like to know more about this curriculum, contact Karen Contreras at kacontreras@coh.org 
Nationally-Known Journalist Describes Final Days of His Elderly Parents’ Lives in TIME Magazine
ELNEC Trainer and National Faculty Member Has Letter to the Editor Published
On June 11, 2012, the weekly-published TIME magazine included a story by journalist Joe Klein titled How to Die: What I Learned from the Last Days of My Mom and DadThe article described the last few years and days of his 90+ year old parents who died from dementia and other co-morbidities. His journey was not surprising, as he described healthcare providers wanting to do “everything” to sustain his parent’s feeble bodies. He goes on to explain how he knew there had to be a better way and he finally found healthcare providers who were bold in talking about death and how to prevent suffering and pain through excellent palliative care. 
The following week, ELNEC trainer and national faculty member, Marian Grant, DNP wrote a response to the editor, “As a palliative care nurse practitioner who often sees patients like Joe Klein’s parents in the hospital, I appreciated his forthright article.  It’s too bad he was not adequately informed earlier in his parents’ care that feeding tubes for people with end-stage dementia don’t help them get stronger or live longer.  Many of us are working to improve the quality of life for people with serious illness, but we need the public to be aware of and to demand these services.”
If you missed reading this article, you can see Joe Klein discuss the death of his parents at
Team of ELNEC Trainers Provide Palliative Care Education in Malaysia
Pictured from left to right:
Gay Walker, Wolfgang [their driver], John Lunn, Barbara Head,
Shakila Punithakumari, and Annie Jacobs
John Lunn has been an ELNEC trainer for 5 years. John is a registered nurse and an ordained minister who is committed to improving palliative care in India, Liberia, and Malaysia. Because of his dual-role as nurse and minister, he has unique opportunities to attend to the body, as well as to the spirit and the soul. In June, he led a team of 5 to Malaysia for the sole purpose of educating nurses and other healthcare professionals in palliative care. Barbara Head, PhD, RN, CHPN, ACSW, Assistant Professor at the University of Louisville and Gay Walker, RN, CHPN, Manager and Program Developer at  Providence Trinity Kids Care in Torrance, CA. joined John and Shakila Punithakumari and Annie Jacobs from India to present 2 weeks of ELNEC training across Malaysia. Training sessions occurred at the Assunta Hospital, which has a palliative care center across the street, and the Tun Tan ChengLock College of Nursing. Nurses, as well as physicians and chaplains attended this course of 140 participants. A second course was held on the island of Borneo. The establishment of hospice and palliative care in Borneo started in 1994.The team was pleasantly surprised to see the tremendous work that had occurred there over the past 18 years. Five schools of nursing sent students and faculty to receive ELNEC training. An additional 110+ people attended the seminars in Borneo. What a difference this team of 5 made.  Over 250 nurses and other healthcare team members were trained in palliative care during this two-week mission. “When each participant received their certificate, it was as if they were walking through a new open door,” stated Gay Walker. 
ELNEC Project Directors Attend Celebration of 20 Years of Hospice and Palliative Care in Brosov, RO
Pictured from left to right:
Nicoleta Mitrea, Pam Malloy, Gabriela Burlacu, Rose Virani, and Irina Tiurin
Rose Virani, RNC, MHA, OCN, FPCN, Senior Project Director of ELNEC at City of Hope and Pam Malloy, MN, RN, FPCN, Director of the ELNEC Project at AACN, participated in a one-day celebration of hospice and palliative care at the Hospice Casa Sperantei in Brasov, Romania, a hospice that has been a house of comfort to the citizens of Brasov for 20 years.  Because of its many successes, other countries throughout Eastern Europe are wanting to learn from them.  Understanding that nurses and physicians cannot practice what they do not know, two workshops were held to begin the process of writing competencies for palliative care  that could be adapted for other countries throughout Eastern Europe.  Nurses and doctors from such countries as Albania, Georgia, Greece, Moldova, and Poland were in attendance.  Both Rose and Pam assisted with this opportunity of beginning to envision competencies needed to train future nurses and physicians in excellent palliative care.
First ELNEC-German Train-the-Trainer Course Takes Place
Pictured from left to right: Bea Werner and Silke Walter
Using the newly translated ELNEC-German curriculum, trainers Silke Walter and Bea Werner began strategically training 10 nurses in palliative care at the Freiburg University Hospital in Freiburg, Germany in June 2012. Much of the training took place in small groups, using case studies. The feedback from the participants was outstanding. This pilot course is just the beginning, as both Silke and Bea begin training more nurses. The next course will take place in the Spring of 2013.
Did You Know?
In the first 6 months of 2012, the ELNEC Project Office has received notification forms from 128 ELNEC trainers. Education sessions have been registered by ELNEC trainers in 30 states, the District of Columbia and several international countries (Krygykystan, Mexico, Malaysia, Korea, and Saudi Arabia).  Most of the trainings are occurring with the ELNEC-Core curriculum (76), followed by 22 ELNEC-Pediatric Palliative Care, 10 ELNEC-for Veterans, and 2 for ELNEC-Critical Care. Trainers are also providing train-the-trainer courses: 7 for ELNEC-Core, 2 for ELNEC-For Veterans, 1 for ELNEC-For Veterans/Critical Care, 1 for both ELNEC-Pediatric Palliative Care and ELNEC-Critical Care. 
Remember: If you are planning to provide an ELNEC course, you must notify the ELNEC Project Office by submitting a notification form. To obtain this form and to review other resources on how to plan an ELNEC course, go to http://www.aacn.nche.edu/elnec/planning-elnec-course
For any questions, contact Pam Malloy at pmalloy@aacn.nche.edu
Remember, you should not be providing ELNEC courses with a CD older than 4 years old (2008 or older). If you have completed an ELNEC train-the-trainer course and need to purchase the 2012 ELNEC CD, contact Pam Malloy at pmalloy@aacn.nche.edu. If you do not plan to hold an ELNEC course until 2013, it is recommended that you wait and order the ELNEC 2013 CD, which will be available after February 1, 2013.  There will be some substantial updates in 2013. ELNEC-Core, Pediatric Palliative Care and Critical Care are updated annually.
Let Us Hear From You!
We are interested in your thoughts and suggestions about end-of-life nursing issues. What would you like to see in this newsletter? Do you have a story to share about how end-of-life nursing education has made a difference for your patients and their families?
Please forward your suggestions or comments to:

Pam Malloy
ELNEC Project Director
202-463-6930 X238
End-of-Life Nursing Education Consortium (ELNEC)