Improving End-of-Life Education for Nurses

Betty Ferrell and Rose Virani recall how early RWJF interest in the End-of-Life Nursing Education Consortium (ELNEC) translated into a sustained and ever expanding educational effort.

From 2000—2004, the Robert Wood Johnson Foundation (RWJF) provided funding to the End-of-Life Nursing Education Consortium (ELNEC) to help develop a palliative care curriculum, and for holding eight national courses for practicing nurses, nursing faculty, and CE providers. Based on post-course data, over 900 nursing faculty were trained in the first four years of the project, representing 65 percent of baccalaureate nursing programs in the United States, and 45,000 nursing students received education in palliative care through the use of the ELNEC materials. This initial four-year funding set the stage for future opportunities to reach thousands of nurses over the next years. To date, over 14,000 nurses and other members of the interdisciplinary team have attended one of 115 national/international train-the-trainer courses. These trainers have returned to their institution and trained over 390,000 health care professionals. ELNEC has been presented in 73 countries, and translated into six languages.

Due to the immense palliative care education needs of specialty nurses, several ELNEC curricula have been developed since RWJF funding ended. Because of the initial funding by RWJF and the success of these early years, other national funders followed RWJF's commitment to this project. For example, between 2003 and 2007, the National Cancer Institute (NCI) funded four national courses for graduate nursing faculty (ELNEC-Graduate), and four national courses for oncology nurses (ELNEC-Oncology). The Aetna Foundation provided funds for two ELNEC-Pediatric Palliative Care courses held in 2005 and 2006. The Archstone and California HealthCare Foundations (CHCF) provided funding for ELNEC-Geriatric and ELNEC-Critical Care between 2006-2010. In 2010, the Department of Veterans Affairs (VA) funded six ELNEC-For Veterans and 2 ELNEC-For Veterans/Critical Care courses for nurses working in VA facilities (2010-2013). In 2011,CHCF funded the development of ELNEC-For Public Hospitals, which provided training to 16 safety net hospitals across the state of California. The Milbank Foundation for Rehabilitation will fund an ELNEC-For Veterans course specifically for nursing faculty in November 2012. Open Society Institute and Bristol-Meyers Squibb Foundations have funded many international courses.

All of these opportunities listed above would never have occurred had RWJF not begun this funding in 2000. The funding allowed the ELNEC Project Team to begin this work and to envision the need for continuing this education. By December, 2012, 17 national trainings will have taken place across the U.S. just this year. In the past 12 months, ELNEC-International has been presented in Mexico, Czech Republic, Hungary, Russia, Poland, Romania, South Korea, Japan, Philippines, and Singapore. In the first six months of this year, ELNEC trainers have registered 128 regional ELNEC courses across the U.S. and in six international countries. Courses for 2013 are shaping up and it will be another big year, as a new curriculum will be developed for advanced practice nurses.

Thank you, RWJF, for your commitment to ELNEC in the early years. None of the work described here would have occurred without your vision for this sacred work. Happy 40th!

—Betty Ferrell, PhD, RN, MA, FAAN, FPCN, and Rose Virani, RNC, MHA, OCN, FPCN, City of Hope