Learning with ELNEC in Hawaii

At the memorial

At the War Veterans Memorial in Honolulu, with Jeannie White

A few weeks ago, Ted and I had the privilege to be invited to attend the ELNEC 20th Anniversary Summit in Hawaii.  ELNEC, the “End-of Life Nursing Education Consortium (ELNEC) was launched in 1999 to improve palliative care. In the past 20 years more than 24,000 nurses have attended one of the ELNEC Train-the-Trainer courses and have then taught more than 726,000 nurses and other healthcare providers worldwide.

Dr. Betty Ferrell has been the visionary leader of ELNEC while Pam Malloy has filled the immense role of Project Director. Pam is preparing to retire in January and she will be missed. I have cherished my connections with Pam and Betty over the years. They have shown great generosity of spirit to Life and Death Matters, have provided testimonials for our nursing texts and resources, and continue to support our work in Latin America.

I delighted to meet again with Polly Mazanec who is working with ELNEC undergraduate, Diane Parker. Diane is helping promote palliative care in Uganda as well as being a dynamic force inmoving pediatric palliative care ahead in her home state. And of course, it was wonderful to meet other faculty and participants from all over the states.

I attended the CORE-ELNEC course, witnessed the challenge of trying to share a large volume of material in a two day course. I was impressed with the binders that each participant received, including materials to teach other nurses.

I look forward to continuing to work with ELNEC, supporting their courses, and being supported in our work. Thank you #ELNEC. And best of best wishes to you, dear Pam, as you explore what retirement will be for you.

Photos below – I really enjoyed meeting up with these incredible people!

With Betty Ferrell, PhD, MA, CHPN, FPCN, FAAN

With Diane Parker

With Pam Malloy, MN, RN, FPCN, FAAN We’ll miss you!

We remember…

George and Harry head off to war, pictured here with sister Janet. Both made it back from war.

George and Harry Gilbert as they head off to war, pictured here with sister Janet. Both made it back.

Clayton Gilbert, 1941

Clayton Gilbert, 1941

As Remembrance Day approaches, I reflect, in particular, on those who fought in wars to provide us with the freedoms we enjoy today. Ann-Marie, Ted and I cherish those in our families who participated in WW I and II. We are grateful that they returned home, and because they came home, that we have life.

I think of my grandfather, Harold Andrew Lees, and his experience in WW I. Near the beginning of the war he was shot, lost his eye, and was then in a German prisoner of war camp. I hear that they treated him well. We still have his warm wool blanket. I remember as a child, he would tell me it was time for me to have a nap, he would then remove his eye, put it in a glass jar, and tell me that he was watching me to make sure that I slept. It is one of my earliest memories – it surely did stick with me!

1st Radar Equipped Aircraft, Year of "Hess" 1941

Patrick Gilbert, (in aircraft) with the first radar-equipped aircraft, Preswick, Year of “Hess” 1941



Major G.H. Gilbert, MC, MM, VD, circa 1921

Major G.H. Gilbert, MC, MM, VD, circa 1921

Roland and Bob Gilbert, with family friend in military

Roland and Bob Gilbert, with family friend in military

A few weeks ago, Ted and I had the privilege to be invited to attend the ELNEC 20th Anniversary Summit in Hawaii. Following the conference we had a few days on the island of Oahu. On the last afternoon, toured by Jeannie White, we visited the War Veterans Memorial in Honolulu. We visited the columbarium that holds the ashes of her father. It was exactly 103 years since his birth. I gave thanks to him, for his daughter Punky, I pondered her life growing up in Hawaii, our meeting as young adults, and all that she has meant to me and to us.

As Remembrance Day approaches, I cringe to think how many soldiers hid their memories, tried to hide their terrors, and carried scars through to their deaths. I think of those we know who live with their scars and suffer with PTSD. In their suffering, they surely do not enjoy the same freedoms that I enjoy.

As Remembrance Day approaches, I am aware that the freedoms that I enjoy, are not experienced by all in North America and certainly are not experienced by many people around the world. I wonder what I can do, or what I can stop doing, to help others enjoy greater freedom. I ponder and pray that we can protect or gain freedom without war and violence. And I wonder if this is possible.

As Remembrance Day approaches, I think of you, and wonder what you will be pondering, what you will hope for and what might you pray for.

With kindness


[Photos from Ann-Marie’s family archive]

Voices to Lead | A Modern Application of Florence Nightingale’s Legacy

Guest Post by Angela Bruce, RN

Florence Nightingale in the Crimean War

Photo Credit: www.healinghealth.com

When I think of a single nurse’s voice, Florence Nightingale comes to mind. In the midst of the Crimean War battlefields, the “lady with a lamp” provided compassionate care to the sick and injured, murmuring words of comfort and offering a touch to frightened boys, some crying out in distress. In the squalor Florence triaged as she went, knowing that so many needed care and that few would survive to see another day. While Florence is known as the “lady with the lamp” she also used her voice to effect change. She galvanized others to lead with their voices and demand changes. Voices that said it was not acceptable that ten times as many soldiers died in the Crimean War from infectious diseases than from injuries, and that it was also not acceptable that hospital floors in England were covered in straw that was matted with urine and blood. These voices for led to the sanitary conditions and standards of care that we have today.

Today, there are still many serious issues affecting health care where voices that lead could effect change, such as:    

  • Lack of access to care for any people in need
  • Scarcity of resources, e.g., personnel, diagnostic services and so on
  • Non-essential antibiotic use in a world of increasingly resistant organisms
  • Restricted access to opioids for people experiencing pain and other severe symptoms, in response to overdose deaths and the Opioid Crisis.

I hope nurses can agree that these are urgent issues.

Voices to Lead for Palliative Care Education

Voices to lead can help ensure hospice and palliative care education for everyone

Photo Credit: https://moments.nhpco.org/news-blogs/hospice-photography

Each of the serious issues listed above directly affects the capacity of health care professionals to provide hospice, palliative and end-of-life care. In 2018 the Government of Canada’s Framework on Palliative Care in Canada Act acknowledged the need to prepare caregivers in their long term goal that stated, “… all providers have increased capacity to deliver quality (palliative) care.” Preparing primary care teams to integrate palliative care for individuals with any life-limiting illness, from early in the disease process through to and following death, in all care settings will help address the serious issues listed above. Using our voices together to integrate and strengthen palliative care education in core curriculum has the potential to prepare health care professionals to deliver palliative care by:

  • Placing the topic of death on the table as a normal part of living and a topic for discussion.
  • Encouraging information sharing, advance care planning and discussions of goals of care.
  • Supporting the intentional use of emergency departments and acute hospital admissions.
  • Supporting informed and effective prescribing of medications for symptom management (including safe prescribing of opioids).

Providing learner-centered palliative care education in the workplace, and mentoring individuals before, during and after education, may also inspire more members of the health care team to seek out additional education and become specialist palliative care providers.

With the aging population, limited resources, and the desire to provide excellent care for people with any life-limiting illness, palliative care needs to be part of core curriculum for every member of the health care team.

Just as our predecessors used their voices to lead and improve care for today, let us join our voices to lead and improve care for tomorrow. 

What are PSWs saying about the text, Integrating a Palliative Approach?

Life and Death Matters reached out to a few colleges and hospices using the text, Integrating a Palliative Approach: Essentials for Personal Support Workers, and companion resources in their teaching  and asked permission to survey students about their learning experiences in hospice and palliative care. An online survey was distributed to individuals who used the resources and were completing their practicum, had graduated or had completed a self-study program. The survey results resoundingly endorsed the text, Integrating a Palliative Approach: Essentials for Personal Support Workers, as a positive learning tool for learning to provide hospice, palliative and end-of-life care.

In the survey, students were asked to reflect on their learning experiences and indicate which statements they agreed with. These are some of the results:

  • 80% indicated “I will keep this text and continue to use this in my practice.”
  • 75% indicated  “I know how to support a person experiencing common symptoms of life-limiting illness”
  • 74% indicated “I strengthened my skills for communicating with people experiencing life-limiting illness and their family.”
  • 83% reported “I learned why self-care is important, and how to provide self-care.”

Students self-reported what they had learned from the text and companion resources. The results indicate the percentage of respondants who reported learning each topic from the text and resources.

  • 90% – How to recognize different patterns of dying
  • 88% – Ways to prepare myself for providing hospice and palliative care
  • 86% – Strategies for communicating with a person and family about difficult topics
  • 83% – How to recognize, observe, record and report when a person is experiencing a common symptom, e.g., pain.
  • 83% – The different ways people experience loss and grief, and how to provide appropriate support
  • 88% – The common changes in the last days and hours of life and how to support a dying person and family
  • 86% – How to provide self-care to maintain my personal health when working in hospice and palliative care.


This survey strongly supports teaching hospice, palliative and end-of-life care to PSW students using the text, Integrating a Palliative Approach: Essentials for Personal Support Workers, and companion workbook, podcasts and videos.

There are more results, including the interview of instructors to report. Look for that information in upcoming blog posts.