Course 3: End of Life Care Management for Nurse Practitioners
April 24, 2023 – June 4, 2023
6 week course
Delivery Format: Online
This 6-week online course focuses on end of life care for clients with progressive disease. Participants will explore “what changes” with conversations and symptom assessment & management nearing end of life. They will examine active dying and post death care, interventions, role & responsibilities of Nurse Practitioners. A case-based approach will be used to enhance learning and application.
This is the third of three online courses as part of the Certificate in Palliative Care for Nurse Practitioners: Core Competencies for NP Practice. Participants successfully completing all three courses within a two-year period will receive the continuing education certificate. The three courses are:
- Course 1: Integrating a Palliative Approach to Care and Essential Communication Skills for Nurse Practitioners
- Course 2: Complex Symptom Management in Palliative Care for Nurse Practitioners
- Course 3: End of Life Care Management for Nurse Practitioners
By the end of this course participants will be able to:
- Articulate the Nurse Practitioner’s role in providing competent end-of-life care for patients at the end stage of their illness.
- Utilize guidelines & tools for the management of common clinical issues seen during the end–of–life/terminal phase such as deprescribing, hydration and nutrition, and the management of cardiac devices.
- Describe the general signs and indicators of patients approaching end of life.
- Articulate appropriate assessment, diagnosis, and management of specific common symptoms at the end of life.
- Describe incidence, contributing factors, assessment, prognosis & intervention for possible palliative care emergencies at the end of life.
- Discuss palliative sedation indications, initiation, guidelines for interventions & monitoring, and support for families & staff during.
- Describe the management of Covid-19 symptoms for the end of life including decision-making, and non-pharmacological and pharmacological interventions.
- Discuss current state of MAiD in Canada and the Nurse Practitioner’s role in supporting patients’ choice for MAiD: including process for exploring requests, eligibility criteria, procedural & monitoring guidance/requirements, and support for family.
- Identify the Nurse Practitioner’s role after a patient’s death.
- Distinguish between healthy & unhealthy grief and be able to identify risk factors/signs of complicated grief.
The certificate is for Nurse Practitioners, (and/or Nurse Practitioner Program students), and those in Advanced Practice and/or CNS roles who, as part of their routine practice, may be responsible for the care of adult clients with progressive and life-limiting illnesses. The practice setting may include acute care, long-term care, community, primary care or private practice.
Course participants must hold current registration as a Nurse Practitioner in their province (or as a Registered Nurse enrolled in a Nurse Practitioner program; or working in an Advanced Practice Role)
This course is a 6-week course delivered through the University of Toronto’s learning management system (Quercus). It is primarily self-paced; however participants are required to engage in discussions and submit activities/assignments within identified timelines (weekly). It is estimated that up to 8 hours of study per week is required for successful completion. The course will utilize a series of case scenarios to enhance learning and application.
In each of the 6 weeks, participants are expected to:
- View an e-learning module
- Review required readings
- Actively engage with the course material by participating in the learning activities/assignments
For this course, the learning activities / assignments include:
- Three on-line discussion activities which provide opportunity for participants to learn from the varied experiences, roles and perspectives of others
- Two short assignment/case quizzes
- Two LIVE (via Zoom) sessions will take place for faculty & participants to engage with one another in a group discussion (alternative option is also available for this activity for those unable to attend)
Date Topic Evaluative Components Pre-course access will be available to allow for testing of computers and general navigation. Part 1: General Approaches to Care and Conversations at End of Life Week 1
- Transition into End-of-Life phase (PPS 40 to 30%)
- Conversation changes: goals of care; decision making process regarding interventions at the end of life; Planning for the death including place of death & support for families.
- Domains of practice implications for Nurse Practitioners
Discussion Board Post Part 2: Active Dying Care & Management Week 2 Specific Symptom Presentation and Management at End of Life
- System specific indicators of approaching the end of life (neurological, respiratory, integumentary, GI and GU, and total pain)
- Assessment, diagnostics (if required), causes, non-pharmacological and pharmacological management of specific common symptoms at end of life.
Case/Quiz Assignment #1 Week 3 Palliative Emergencies at End of Life
- Seizure, Superior Vena Cava Syndrome, Spinal Cord Compression, Hypercalcemia and Massive Bleeding or Hemorrhage
- Assessment, diagnosis, prognosis and non-pharmacological and pharmacological management of each
Case/Quiz Assignment #2
LIVE Case Study Discussion/Participation
Week 4 Palliative Sedation for Refractory Symptoms
- Definition, indication, incidence & initiation of palliative sedation
- Withdrawal/ withholding of treatment issues.
- Support for family & caregivers
COVID-19 EOL Care Management
Discussion Board Post Week 5 Medical Assistance in Dying (MAiD)
- Decisions, process, & management
Discussion Board Post Part 3: Post Death Care & Management Week 6
- Death determination, certificate & arrangements
- Review types of grief and potential interventions
- Care for caregivers/team
LIVE Case Study Discussion/ Participation
Valerie Cooper MN, NP-Adult, CHPCN(C)
Nurse Practitioner, Hospice Palliative Care Program
Home and Community Care Support Services Central East
Francyelle Fernandez RN(EC), NP-Adult, MN, BScN
Nurse Practitioner Palliative Care, London Health Sciences Center
Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto
Karen Lock, RN(EC), NP-Adult, BScN, MN, CON(C), CHPCN(C)
Nurse Practitioner, The Edwin S.H. Leong Geriatric Supportive Care Outreach Program & The Freeman Centre for the Advancement of Palliative Care, North York General Hospital
Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto
Wendy McEwen, RN(EC), NP-PHC, BScN, MScN, CHPCN(c)
Nurse Practitioner, Palliative Care Consultation Team, Medicine Program, London Health Sciences Centre, University Hospital, London, ON. Consultant Lawrence S. Bloomberg Faculty of Nursing’s Centre for Professional Development, University of Toronto.
Early Bird price (ends March 23, 2023) $715 + HST Regular price (starts March 24, 2023) $785 + HST U of T Nursing Alumni save 15%* $670 + HST U of T Nursing Adjunct and Status Faculty save 15%** $670 + HST NPAO Member save 15%*** $670 + HST
A group discount rate is available for site groups of three or more people. For details please contact firstname.lastname@example.org.
- Refund Policy – To withdraw from the course and receive a refund, your written request must be emailed to email@example.com by March 23, 2023. No refunds will be given after this date. All refunds are subject to an administration fee of $100 + tax. As an alternative, a colleague may attend in your place. Please send your substitution request at least 7 days before the course begins.
- Advanced registration is required. Registration deadline: April 16, 2023.
- U of T Nursing Alumni discount is available to BScN, MN, PMNP Diploma, MScN or PhD graduates of the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto.
- U of T Nursing Faculty discount is available to individuals with a faculty position, adjunct or status appointment, or are a Clinical Instructor (current academic year only) at the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto.
- NPAO (Nurse Practitioner Association of Ontario) members may register at the NPAO rate which is 15% off the regular rate. Please note, your name will be used to confirm that you are a member of the NPAO.
- Applicable taxes (13% HST) will be added to the registration fees.
- Course Cancellation Policy – The University reserves the right to cancel courses due to unavailability of instructors, facilities or insufficient enrolment. Decisions on course cancellations are made at least 15 calendar days prior to the course starting date, so early registration is recommended. If you enroll in a course that is subsequently cancelled, you may transfer to another section of that course if an alternative is available; or you may receive a full refund. We are not responsible for travel fees or any expenses incurred by you.
The Ontario Student Assistance Program now offers funding for micro-credentials (short training programs offered by post-secondary institutions), including a number of courses offered by the Centre for Professional Development. This funding initiative is part of Ontario’s micro-credentials strategy, helping learners access more opportunities to train or upskill for in-demand jobs through loans and grants.
How to Apply for OSAP Funding
This course is OSAP approved (more approved courses are listed below, and you can also verify on the Micro-credentials Portal). To apply for financial assistance through OSAP you will need to establish an OSAP account. You must apply before the course completion date. Visit Ontario.ca/OSAP.
Once you have registered for an eligible OSAP Micro-credential program, the University Registrar’s Office requires a Micro-Credential Program information form to be completed to process your OSAP application. Please fill out the top section of the form and send it to firstname.lastname@example.org to get assistance in completing the form.
Download the Micro-credential Program Information Form (PDF)
For questions regarding the OSAP Micro-Credential funding, eligibility or application process, please contact UofT’s Enrolment Services directly at http://uoft.me/enrolment-services, or by phone at 416-978-2190 for assistance.
Eligible courses offered by the Centre for Professional Development
- Advanced Health Assessment and Clinical Reasoning in Primary Health Care: A Review for Nurse Practitioners
- Advanced Ostomy Care and Management
- Complex Symptom Management in Palliative Care for Nurse Practitioners
- Controlled Drugs and Substances: Essential Management and Prescribing Practices
- End of Life Care Management for Nurse Practitioners
- Integrating a Palliative Approach to Care and Essential Communication Skills for Nurse Practitioners
- Leadership & Management in Health Care: Managing Business
- Leadership & Management in Health Care: Managing People
- Leadership & Management in Health Care: Managing Practice, Quality Care & Operational Performance
- Leadership & Management in Health Care: Role, Competencies, and Context
- Mental Health 1 for Nurse Practitioners
- Mental Health 2 for Nurse Practitioners
- Mental Health 3 for Nurse Practitioners
- Mental Health 4 for Nurse Practitioners
- Nursing Education for the Practice Setting: Assessment and Evaluation
- Nursing Education for the Practice Setting: Design, Delivery and Facilitation
- Nursing Education for the Practice Setting: Theoretical Perspectives and Context
- Point-of-Care Clinical Leadership for Managing Quality Care & Operations in Long-Term Care
- Point-of-Care Clinical Leadership for Working With & Leading Long-Term Care Teams
- Point-of-Care Clinical Leadership in the Context of Long-Term Care
- Pressure Injuries and Complex Surgical Wounds: An Advanced Practice Course
- Review of Health Assessment Across the Lifespan
- Role of the Nurse Practitioner and Care of the Hospitalized Adult 1
- Role of the Nurse Practitioner and Care of the Hospitalized Adult 2
- Role of the Nurse Practitioner and Care of the Hospitalized Adult 3
- Role of the Nurse Practitioner and Care of the Hospitalized Adult 4
- Wound Management for Nurse Practitioners and Advanced Practice Nurses: A Best Practice Boot Camp on Lower Extremity Ulcers
Email: email@example.com Website: bloomberg.nursing.utoronto.ca/pd Phone: (416) 978-7688 Address: Centre for Professional Development
Lawrence S. Bloomberg Faculty of Nursing
University of Toronto
155 College Street