“I know my patient needs palliative care, but what do I do next?”

I’ve heard this question countless times from nurses who were frustrated and morally distressed about their inability to provide appropriate palliative care for their patients.

As a nurse, this moral distress was one of the things that ignited my passion for palliative care and end-of-life care in heart failure, which continues to fuel my work today.

After reading an article saying that “heart failure patients need palliative care too” I realized that as a cardiac nurse, my patients were dying, yet they were not being told that this was coming. This prevented them and their family members from completing all of the end-of-life tasks that I’d learned in my ELNEC training were so important:

  • settling their financial and legal affairs
  • handing over their roles and responsibilities to others
  • preparing family and friends
  • completing their bucket lists
  • celebrating their lives with those who love and appreciate them
  • creating their legacies
  • saying  goodbye
  • having a “good death”

In hospitals, I’ve observed that the barrier to palliative care is often either the lack of access to a palliative care team, or physicians’ and surgeons’ reluctance to refer their patients to specialty palliative care. In clinic settings, many physicians are reluctant to talk honestly about the future with their patients, for fear of destroying their hope. Yet as nurses, we are far too familiar with the tragic consequences of this approach.

Because of the many barriers that prevent patients from getting timely access to palliative care, every nurse needs to be ready to provide primary palliative care for patients and families in need.1 This is the goal of the Palliative Nursing Network: to empower nurses in primary palliative care.

Want to learn more? Check out our FREE short course: What You Need to Know About Palliative Care and our Introduction to Primary Palliative Care providing a comprehensive overview of primary palliative nursing with 1 contact hr. ANCC nursing continuing ed for only $20.


1. American Nurses Association Professional Issues Panel. Call for Action: Nurses Lead and Transform Palliative Care. American Nurses Association. http://www.nursingworld.org/CallforAction-NursesLeadTransformPalliativeCare. Published 2017. Accessed October 10, 2017.

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