ANA on the Frontline

Calling for all nurses to lead and transform palliative care

ANA and the Hospice & Palliative Nurses Association (HPNA) have partnered to issue Call for action: Nurses lead and transform palliative care. This call for action supports the belief that seriously ill and injured patients, their families, and communities should receive quality palliative care in all care settings.

“Every nurse should have the knowledge and ability to facilitate healing and alleviate suffering through the delivery of safe, quality, and holistic personcentered primary palliative care,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN.

In January 2016, ANA and HPNA convened the Palliative and Hospice Nursing Professional Issues Panel. This panel was tasked with completing an environmental assessment, examining palliative care nursing within today’s healthcare system, and identifying steps and strategies for nurses to lead and transform palliative care. The call for action, which has been approved by members of the ANA and HPNA Boards of Directors, outlines 12 key recommendations that support the conclusion of the call for action and indicate the steps necessary to achieve quality primary palliative nursing, regardless of setting:

1. Adopt the End of Life Nursing Education Consortium curricula (core, geriatric, critical care, pediatric, advanced practice registered nurse [APRN], and online for undergraduate nursing students) as the standard for primary palliative nursing education for pre-licensure, graduate, doctoral, and continuing education for practicing registered, vocational, and practical nurses, and APRNs.

2. Petition the National Council for State Boards of Nursing to increase palliative care content on the NCLEX-RN and NCLEX-PN exams.

3. Encourage state boards of nursing with continuing education re-licensure requirements to mandate inclusion of palliative care content.


4. Advocate the use of the National Consensus Project for Quality Palliative Care Clinical Practice Guidelines for Quality Palliative Care in the development, implementation, and evaluation of specialty, evidence-based palliative care services for all organizations.

5. Recommend that all specialty nursing organizations review RN and APRN practice standards to include primary palliative nursing care and develop resources and position papers to support and advance primary palliative nursing.

6. Fund, develop, and evaluate innovative palliative care models to address workforce challenges and the needs of communities of color, underserved populations, and other vulnerable groups, such as Native Americans, persons with intellectual and developmental disabilities, and others in rural and urban areas.

7. Convene a thought-leader summit to address practice barriers and develop initiatives to implement primary palliative care.

8. Incorporate primary palliative nursing as part of the American Nurses Credentialing Center Magnet Recognition Program® and Pathway to Excellence Program®, American Association of Critical-Care Nurses Beacon Award for Excellence, Academy of Medical-Surgical Nurses Prism Award, and other organizational and unitbased credentialing and recognition programs.

9. Conduct intervention studies that test strategies to alleviate compassion fatigue and moral distress to maintain a healthy workforce.

10. Promote equitable reimbursement and reduction of barriers by all payers for RN and APRN services related to palliative and hospice care.

11. Support the funding and development of palliative care services for communities with limited resources.

12. Position nurses at decision-making and policy-setting venues, such as healthcare and regulatory boards, to address palliative care needs.

Nurses are encouraged to lead and transform palliative care in practice, education, administration, policy, and research. Opportunities abound for nurses in community hospitals and clinics, academic medical centers, underserved and rural communities, home, and other healthcare settings to provide primary palliative nursing care when specialists are unavailable.

Access Call for action: Nurses lead and transform palliative care, an extensive compendium of valuable resources and additional action opportunities.

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