Backstory: Teaching nurses about palliative and end-of-life (EOL) care is very important in health care settings. The objective of this research was to evaluate nurses' perceived competence in delivering palliative and end-of-life care to hospitalized patients. This research examined nurses from 25 pediatric and adult acute and critical care units (ICU; N = 583). The examination of quantitative data was both descriptive and correlational. Qualitative data analysis detected themes of participant concerns. The examination of the data showed that ICU nurses think they are far more competent in palliative and end-of-life care (p 0001). When nurses had more than ten years of experience, their mean scores were much higher (p.0001). Open-ended comments revealed apprehensions about enhanced communication practices, decision-making, and the promotion of continuity of care. The findings provide direction for the creation of palliative and end-of-life care nurse education programs customized to meet the distinct requirements of each unit, including staff attributes, patient demographics, and the intensity of care required.

Health care workers have a professional duty to provide high-quality care to persons who are reaching the end of their lives (EOL). Palliative care enhances the quality of life for patients and their families confronting life-threatening illnesses, from the moment of diagnosis until the end of life (World Health Organization, 2015). About 28% of deaths happen in hospitals (Centers for Disease Control and Prevention [CDC], 2016), so it's important for nurses in hospitals to know how to provide basic palliative and end-of-life care, such as how to talk to patients, work with other professionals, and manage symptoms (Institute of Medicine, 2014). Nursing professionals may not consistently possess the requisite preparation to provide high-quality palliative and end-of-life care to patients and families. Commonly acknowledged obstacles include insufficient experience, education, or engagement in the patient's care plan (Espinosa, Young, & Walsh, 2008; Harris, Gaudet, & O’Reardon, 2014; Sato et al., 2014; White & Coyne, 2011).

Professional organizations like the American Association of Critical-Care Nurses and the American Nurses Association have written clinical practice guidelines and procedures to help nurses learn about and improve their abilities in end-of-life care. The American Association of Colleges of Nursing (2008) has delineated fundamental skills pertaining to palliative care for undergraduate nursing courses in the Essentials of Baccalaureate Education for Professional Practice. Dr. Price is a Clinical Assistant Professor, Dr. Strodtman is an Assistant Professor Emerita, Ms. Miller is a Research Assistant, Ms. Zybert is an Honors Student, Ms. Ghosh is a Statistician Intermediate, University of Michigan School of Nursing, and Dr. Montagnini is a Professor of Medicine at the School of Medicine, University of Michigan, and Veterans Affairs Ann Arbor Healthcare System; Dr. Oldfield is Co-Chief Resident, and Dr. Policht is a Resident at the Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan; and Dr. Smith is a Lead Psychologist and Associate Professor at the Clement J. Zablocki Veterans Affairs Medical Center and Medical College of Wisconsin, Milwaukee, Wisconsin. Nursing Practice in a Professional Setting. The End-of-Life Nursing Education Consortium and the Center to Advance Palliative Care are two national initiatives that have done a lot to advance the education and training of nurses in palliative and end-of-life care. The American Association of Critical-Care Nurses (2016) has included parts on palliative and end-of-life care to its Essentials of Critical Care Orientation programs. More than 1,100 institutions in the US and Canada utilize these modules. To fully cover the key areas of palliative and end-of-life care, these programs need a lot of training. To make the best use of time and resources, it is best to focus instruction on the nursing groups that care for patients and families who require palliative or end-of-life care the most often. Moreover, the educational requirements for nurses in palliative and end-of-life care may differ based on the patient demographic and acuity level, as well as the lived experiences of the nursing personnel (Montagnini, Smith, & Balistrieri, 2012). Unit leadership may more effectively handle staff education by concentrating on elements of palliative and end-of-life care that pertain to specific staffing requirements or significant components of care for their particular patient demographic. This research aimed to ascertain and compare the foundational training requirements in palliative and end-of-life care for nurses employed in adult and pediatric intensive care units (ICUs) and acute care environments.