Nursing homes across the nation have been heavily impacted during the Covid-19 pandemic. During its peak in Connecticut, nearly 1 out of every 10 nursing home residents represented more than 70 percent of all Covid related deaths in the state. The devastating mortality rate not only impacted the nursing home residents but also the health care workers providing care. With families unable to visit the homes, nurses were tasked with conducting difficult end-of-life conversations by phone.

As part of the mission of the Kanarek Center for Palliative Care Nursing (KCPC), Professor Eileen O’Shea, DNP, APRN, center director, and Associate Professor Alison Kris PhD, RN, FGSA partnered with the Connecticut Coalition to Improve End-of-life Care on an outreach project focused on getting critical information into the hands of these front-line workers. The end-of-life phone conversation guidelines, were provided by the Center to Advance Palliative Care (CAPC), which is part of the Icahn School of Medicine at Mount Sinai, and Serious Illness Conversations. The guide included scripts on how to approach serious illness conversations and how to have a telephone conversation with someone who is actively dying.

“Over the years the Kanarek Center has seen a resistance to embrace this type of education. It is a part of life, but difficult,” explained Dr. O’Shea. “I think now, nationally, the pandemic has challenged us in many ways and has drawn attention to advanced care planning.”

In nursing homes, Dr. Kris pointed out that physicians are present once a month leaving nurses to have these conversations. Dr. Kris said, “When a patient takes a turn for the worst and becomes very ill, quickly, as we have seen with the Covid-19 pandemic, the nurses are the initiators of these conversations.”

In conjunction with National Nurses Week in May, and with the generous support of the Kanarek Center for Palliative Care, a small army of dedicated volunteers participated in heroes’ parades and distributed to more than 1,000 nursing home health care providers, information guides to help facilitate end-of-life conversations. 

While the global health crisis highlighted a whole new level of complexity and challenge around these difficult conversations due to family members’ inability to be with their loved ones, Fairfield’s Egan students have been well prepared to have these difficult conversations via simulation training they receive at the Kanarek Center. 

“We have a really important role in having palliative care and end-of-life discussions,” said Dr. O’Shea. “The practice that we do at the KCPC is critical. It’s not an easy conversation nor is it intuitive, but it can become a skill if it’s practiced.

Enhancing a patient’s quality of life, providing patients and families with supportive and spiritual care, and incorporating an interdisciplinary healthcare approach towards pain and symptom management, are all essential criteria to be met in the field of palliative and end-of-life care. Since its inception, the Kanarek Center has educated hundreds of nursing students and practicing nurses on the importance of providing compassionate, holistic, and high-quality care for patients with life-threatening conditions through comprehensive curriculum and clinical experiences.

To learn more about the Kanarek Center for Palliative Care, visit www.fairfield.edu/kanarek.