Center for Nursing Excellence in Palliative Care

Improving palliative care for patients with life-threatening illness across the lifespan and their families by generating palliative nursing leaders through education, practice, and research.

Palliative care is patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing the physical, intellectual, emotional, social, and spiritual needs and facilitating patient autonomy, access to information, and choice (National Consensus Project for Quality Palliative Care, 2013).

Palliative nursing is an evidence-based nursing practice that includes the assessment, diagnosis, and treatment of human responses to actual or potential life-limiting illness within the context of a dynamic caring relationship with the patient and family, in order to reduce or relieve suffering and optimize health. The essence of palliative nursing is honoring the individual patient in her or his journey; attending to psychological responses to the end of life, social and cultural factors, and spiritual aspects of care.

Research

Advancing Knowledge to Improve Health Outcomes

Advancing Knowledge to Improve Health Outcomes

Current Nursing Research in the Areas of Palliative Care

  • End-of-life communication, treatment decision making, and surrogate decision making
  • Quality of life
  • Symptom science
  • Pain and symptom management
  • Family caregiving
  • Palliative care integration into advanced illness management

Pre-Doctoral and Post-Doctoral Research

Former Post-Doctoral Fellow

Hyejin Kim, PhD, RN is a postdoctoral fellow at the Center for Nursing Excellence in Palliative Care at Emory School of Nursing. She received her PhD in Nursing (with a focus on palliative and end-of-care) from the University of Pennsylvania. She was a Ruth L. Kirschstein NRSA predoctoral (F31) fellow and a 2013-2015 National Hartford Centers of Gerontological Nursing Excellence Patricia G. Archbold scholar.

Palliative and end-of-life care, particularly goals-of-care discussion, surrogate decision making, and treatment decision making; dementia and long-term care; qualitative research.

Hyejin’s research is focused on improving the quality of care and promoting palliative care for nursing home residents who have lost decision-making capacity, and their surrogates. Her research areas include goals-of-care discussion, surrogate decision making, treatment decision making, dementia care, and long-term care. Her dissertation study focused on Physician Orders for Life-Sustaining Treatment (POLST) discussions between primary care providers and surrogates for individuals with advanced dementia. This study described characteristics of provider-surrogate communication during POLST discussions and surrogates’ experiences of engaging in the discussions. Currently, Hyejin is conducting a study on healthcare decision making for nursing home residents who have lost decision-making capacity but do not have an available surrogate (often called “unbefriended”).

Current Pre-Doctoral Fellows

Carrie Henry, MSN, CNM, RN is a PhD student, with expected graduation in 2021. Her research focuses on improving care for African American families experiencing perinatal loss. She received her BSN from The University of Alabama in 2001 and her MSN from the Medical University of South Carolina in 2005. Her clinical background is in midwifery.

Carolina Gustafson, MSN, ACNP-BC is a current first year PhD student interested in end-of-life and palliative care interventions for young adult patients and their families in critical care settings. Currently she is studying the experiences of young adults with cystic fibrosis with a focus on palliative care and advanced care planning and transitions from pediatric to adult care. She graduated with her MSN from the Yale School of Nursing in 2018 as an Acute Care Nurse Practitioner where her masters thesis examined the palliative and end-of-life experiences of Muslim oncology patients. Her undergraduate degree was in Science, Technology, and Society with a focus on gender and science. She wrote her senior thesis on the gendered history of nursing through the lens of the development of hospice in America as a nurse-led movement.

Interdisciplinary Group for Integrative Scholarship in Palliative Care

The Center aims to serve as a catalyst for successful and optimized interdisciplinary collaboration in palliative education, practice, and research. To promote interdisciplinary scholarship, the interdisciplinary group for integrative scholarship in palliative care brings palliative educators, practitioners, and researchers from multiple disciplines on campus together to promote interdisciplinary scholarship.

Faculty who are interested in joining this group, please contact administrative assistant Dianne Winsett at dwinset@emory.edu.

Palliative Care Pilot and Dissertation Research Grants

This planned initiative is to fertilize innovation in palliative care research and help accelerate development of palliative care research programs for junior investigators and student researchers.

2018-19 PILOT STUDY

Examining the Relationship between Economic Hardship and Quality of Life in the Outpatient Oncology Palliative Care Setting: A Pilot Study

This study will give us information to guide us in creating interventions to prevent and reduce financial hardship and its negative effects on health and well-being. Approximately 1.7 million Americans were diagnosed with cancer in 2018. As numbers of cancer diagnoses increase, costs of cancer care are also increasing, from 59.8 billion dollars in 2002 to 87.5 billion dollars in 2012. More money is spent on individual cancer care than on any other disease in the United States. Patients are responsible for many of the increased costs, resulting in financial hardship to patients. In limited studies looking at specific types of cancer, higher financial hardship has been related to lower quality of life. Little research has been done to describe financial hardship experienced by cancer patients with advanced cancer in the palliative care setting. This group of patients may be experiencing cumulative effects of financial hardship due to their advanced disease status. Therefore, the objective of this research is to describe financial hardship and its association with quality of life in cancer patients with advanced cancer in the palliative care setting. This study includes a one-time visit with approximately 60 patients receiving outpatient palliative care services at Emory or Grady. Research participants will be asked to complete questionnaires about quality of life, financial hardship, and cancer symptoms. The principal investigators are Kate Yeager and Sarah Belcher.

Sarah M. Belcher, PhD, RN, OCN
Postdoctoral Fellow, Biobehavioral Oncology

Kate A. Yeager, PhD, RN, FAAN
Assistant Professor

Practice

Improving Access and Quality, Implementing New Knowledge

The Center for Nursing Excellence in Palliative Care promotes nursing excellence in palliative care practice across Emory Healthcare, including Emory University Hospital, Emory Midtown Hospital, and Johns Creek Hospital, Children’s Healthcare of Atlanta, and Atlanta VA Medical Center. These palliative care settings serve as a valuable clinical arena for nursing students to learn about implementing palliative care principles in clinical practice. Current inpatient and outpatient palliative care services at these settings are provided and managed by the Emory Center for Palliative Care (Director, Tammie Quest, MD).

The Center for nursing Excellence in Palliative Care also promotes developing and implementing innovative palliative care delivery models. Led by Dr. Carolyn Clevenger, the Integrated Memory Care Clinic is an innovative nurse-led outpatient clinic providing comprehensive patient-centered care, including palliative care services, to patients with dementia and their family caregivers.

Education

Building Competencies and Leadership

Fuld Fellowship Program in Palliative Care

The Fuld Fellowship Program in Palliative Care was established in 2015 with generous gifts from the Fuld Trust. The goal of this program is to prepare nursing students to be leaders in improving quality of life for people with serious illnesses and their families by focused palliative care education, interdisciplinary practice, and research activities in their nursing curriculum. The program is led by co-directors, Shella Chawda, NP, and Debbie Gunter, FNP-BC, ACHPN, who are dedicated to nursing excellence in palliative care education and practice.

Fuld Palliative Care Scholars

7th Cohort

Kelvin Flores

Kelvin is a first-year student in the AMSN program from Fredericksburg, VA. He is a 2009 graduate of James Madison University, earning his bachelor's degree in Athletic Training. He obtained his master's degree in Adult and Higher Education with an emphasis in Intercollegiate Athletic Administration from the University of Oklahoma in 2012. For the last 10 years, he has provided sports medicine care to intercollegiate student-athletes, most recently at the University of Texas at Austin. As an athletic trainer, he developed a passion for functional medicine and a desire to advance his skills to provide care to all patients, not just the physically active. Observing the care provided to his grandmother, drew Kelvin to a career in palliative care. He witnessed the impact a palliative care clinician can have on a patient and their family. The guidance and compassion demonstrated to her and his family were of tremendous support during the last couple of years of her life. Kelvin one day hopes to share the same skill set of quality medical care and patient support as an Adult Gerontology Nurse Practitioner.

Tatenda Mangurenje - Tatenda is a first year AMSN student from Gweru, Zimbabwe. She received her undergraduate degrees in Anthropology, Psychology and History from the University of Arizona. She then came to Emory where she is also a PhD Candidate in Anthropology (with a concentration in Medical Anthropology). As an undergraduate, Tatenda worked as a caregiver, providing hospice care to elderly patients suffering from Dementia and Alzheimer’s. This experience provided her the opportunity to both care for and support terminally ill patients and their families through one of the most challenging times of their lives. Working as a caregiver taught her the importance of promoting the dignity and humanity of her patients by helping to alleviate their suffering, which at times simply meant providing an empathetic ear. Additionally, in her dissertation research, Tatenda investigates gun violence in Atlanta, GA, which brings her in contact with individuals and families receiving palliative care. These combined work and research experiences solidified her desire to help both individuals and families with life-threatening or terminal illnesses and to provide them with the care and human dignity that are at the cornerstone of nursing practice. Tatenda intends to work as a Nurse Practitioner and as a Professor of Nursing, providing palliative care to chronically ill adults and their families and teaching as well as training the next generation of palliative care nurses.

Cristina Rael - Cristina is a first year AMSN student from Milton GA, and will be graduating in December 2022. She came to Emory two weeks after graduating from Auburn University with a degree in Microbiology. While there, she worked as a medical assistant at a local primary care office, Auburn Family Medicine. She watched how the nurses interacted with the patients and put the patient’s needs first, and knew that kind of care was meant for her. She also learned that her favorite part of healthcare was treating kids and watching them develop and grow over time. With that, she is most passionate about treating children and providing holistic care to her patients and families. In the future, she hopes to work in pediatric primary care with specialties like cardiology or nephrology.

6th Cohort

Nicole Alexander

Nicole Alexander - Nicole is a second-degree AMSN student from San Francisco, California who will be graduating in December 2021. She comes to Emory having graduated from UC Davis with a degree in Psychology (with an emphasis in Biology). It was while caring for her terminally-ill grandparents that Nicole discovered her passion for nursing and specifically, palliative care nursing. To further her goals of becoming an Adult-Gerontology Nurse Practitioner, she obtained her Certified Nursing Assistant license and volunteered in rural South Africa. When her grandparents were eventually transferred to a skilled nursing facility, she saw firsthand the importance of engaging activities and meaningful relationships for those at the end of their lives. After graduating, Nicole began working at the same facility where her grandparents spent their final months. There, she was able to create new interactive programs for residents and their family members. In the future, Nicole hopes to work as a nurse practitioner and provide palliative care to chronically ill adults while prioritizing their emotional needs.

Bobby Antalek

Bobby Antalek - Bobby is a first year AMSN student from San Francisco, CA. He received his undergraduate degree in Exercise Biology from UC Davis then went on to complete a graduate degree in Physiology (with a concentration in Complementary and Alternative Medicine) from Georgetown University as well as a Masters of Public Health (with a concentration in Community Health Science) from UCLA. Bobby brings a unique combination of life and work experience to Emory. Prior to college, he lived in a rural Zen monastery located in Northern California, where he studied Buddhist philosophy and Zen (Chan) meditation for several years. He initially planned to work as a linguist and special agent for the FBI, but quickly discovered the joys of patient-care as he began working in various hospitals, such as Kaiser Permanente. He has worked for a variety of health organizations, including Kaiser, San Francisco Department of Public Health, National Institutes of Health, Georgetown University Lombardi Cancer Center, and University of California, San Francisco. His passion for exercise and public health also drove him to teach high school strength and conditioning and health education, which included topics such as nutrition, stress management, and screen time. More recently, he worked at the UCSF Airway Clinical Research Center, where he helped leading pulmonologists and researchers in discovering new treatments for lung diseases. While working at UCSF, he also helped care for his mother who suffered from renal failure and had been on dialysis for over 10 years before finally receiving a kidney transplant.

5th Cohort

Ashley Cohen - Ashley is an AMSN student from Leawood, Kansas who will be graduating in December 2020. Her interest in neurodegenerative disorders began in high school when her grandfather was diagnosed with Alzheimer’s. To better understand his disease, she began volunteering at a local retirement home. On the final day that her grandfather was with her family, they were granted a hospice volunteer. Beginning the grief process with this complete stranger was one of the most comforting moments she had ever experienced. She made us realize that with a terminal illness, it is a blessing to allow someone to pass. After this experience with hospice, she knew she wanted her career to be focused on geriatric patients and to be involved in the palliative care community. She majored in neuroscience at Indiana University-- and completed research domestically and internationally. Research showed her that healthcare professionals have a vital role in moving the advances of bench research into the realm of their treatment. She volunteered with the Indiana University Health Hospice and realized that her passion was to follow the nursing model. By pursuing a nursing career, she has the ability to give more one-on-one time to patients who need advocates and providers to help them by providing holistic care with many different complex illnesses.

Calla Michalak - Calla is a second-degree AMSN student from Memphis, Tennessee who will be graduating in December 2020. She came to Emory two weeks after graduating from Michigan State University with a degree in Psychology and minors in Bioethics & Health Promotion. She had chosen healthcare early on in her college career and, as she learned more about the study of nursing, chose it for its holistic and patient-centered approach to care. During her years at Michigan State, she served as a member of the Student Health Advisory Council and worked with the health promotion department to advocate for and address student needs. She also spent her summers working in medically underserved communities both domestically and abroad in Riobamba, Ecuador and Hyden, Kentucky. Those experienced confirmed her desire to work with and in communities that are typically underserved to promote health across the lifespan.

4th Cohort

Haley Lynn - Haley is a second-degree AMSN student from New Jersey. She will graduate from Emory in December 2019. She came to Emory School of Nursing after graduating with a degree in Public Health from American University in Washington, DC. After graduating college, Haley worked at a cancer institute within Boston, Massachusetts for two and a half years. She became familiar with the world of oncology and the unfortunate impacts it has on patients, and the people close to them. Haley enjoys building relationships with patients and admires the holistic care nurses provide. Haley hopes to gain nursing and palliative care skills to offer comfort and aid to patients and families affected by chronic and terminal disease.

Hannah Spero - Hannah is a second-degree AMSN student from San Francisco, California, who will graduate December 2019. She comes to Emory having graduated from UCLA with a degree in International Development Studies and minors in Public Health and African Studies. Hannah has always wanted to make a career out of helping others, and she decided to pursue nursing after interning at a maternal health center in Accra, Ghana, while studying abroad. She loves the personal, hands-on care for others that permeates the nursing profession. After college, she discovered her passion for geriatrics and palliative care through her work as a CNA at the San Francisco VA Medical Center; this is also where she decided to focus her career on homeless and housing-insecure populations. In the future, Hannah hopes to work as a nurse practitioner to provide primary and palliative care to chronically and seriously ill, homeless/housing-insecure adults. In addition, she plans to be a part of health policy advocacy for this vulnerable population.

3rd Cohort - Graduated December 2018

Rachel Behrend

Rachel Behrend - Rachel is a second-degree AMSN student from Bethesda Maryland who will be graduating in December 2018. She comes to Emory having graduated from Bryn Mawr College with a degree in biology. Rachel loves the combination of professionalism and intimacy that characterizes the nursing profession, the lifelong opportunities for intellectual stimulation and growth, and the undeniable chance that nursing will provide to make a positive impact. She has a longstanding interest in movement, pain, and rehabilitation, originally through the lens of basic neuroscience research, which she pursued prior to beginning the AMSN program at Emory. She is now most interested in helping patients with long-term illnesses and chronic pain through rehabilitative methods and palliative care. Rachel hopes to work in a setting that will allow her to provide rehabilitation to those suffering with long-term illnesses who wish to return to their daily activities. She hopes to start her career in a clinic that affords her the time and resources to pursue this, and one day perhaps have her own practice where this will be a primary emphasis.

Emily Buzhardt

Emily Buzhardt - Emily is a second-degree AMSN student from Nashville Tennessee who will be graduating in May 2019. She comes to Emory School of Nursing having graduated from the University of North Carolina at Chapel Hill with a degree in biology. Emily chose nursing due to its patient-focused nature and its holistic model of care, that nurses view the patient as being more than his or her disease. Out of all health care providers, nurses spend the most time with patients. She wants to form relationships with her patients and support them in times of need. On her journey to Emory, Emily worked as a triage and medical assistant and decided that she wanted to pursue a career in oncology because she loved the patients that she worked with as a medical assistant.

2nd Cohort - Graduated December 2017

Maggie Carrillo

Maggie Carrillo

1st Cohort - Graduated December 2016

Andrea Brubaker

Andrea Brubaker

Phillip Dillard

Phillip Dillard

Allysa Rueschenberg

Allysa Rueschenberg

For more information about this program visit the Fuld Palliative Care Scholarship Page

Certification and Continuing Education Programs

Partnering with the Nursing Continuing Education Center, the Center for Nursing Excellence in Palliative Care identifies the needs of professional development in palliative care and developing innovative and high quality continuing education programs to meet those needs, which ultimately can improve palliative care quality.

In addition to the successful wound, ostomy, and continence nursing education program, care coordination and pain management CE programs will be launched in the near future. Also a new initiative, evidence-based advance care planning summer institute, is underway.

Fuld Visiting Scholar Program

Annually, the Center invites an eminent scholar in the fields of palliative care to inspire faculty, students, and local healthcare communities with a vision of excellence in palliative care education, practice, and research.

Leadership

Center Director & Research Core Leader

Mi-Kyung Song, PhD, RN, FAAN

Professor

Director, Center for Nursing Excellence in Palliative Care

Emory School of Nursing

Dianne Winsett

Dianne Winsett

Administrative Assistant

Emory School of Nursing

Executive Committee

Sandra B. Dunbar, PhD, RN, FAAN, FAHA, FPCNA

Associate Dean for Academic Advancement

Charles Howard Candler Professor

Emory School of Nursing

Elizabeth J. Corwin, PhD, RN, FAAN

Associate Dean for Research

Professor

Emory School of Nursing

Amy Dorrill, MBA, FAHP, CFRE

Associate Dean of Development and Alumni Relations

Emory School of Nursing

Education Core Leader

Carolyn K. Clevenger, DNP, RN, GNP-BC, AGPCNP, FAANP

Associate Clinical Professor

Assistant Dean for MSN Education

Emory School of Nursing

Susan Shapiro, PhD, RN, FAAN

Associate Dean for Clinical Community Partnerships

Clinical Professor

Emory School of Nursing

Debbie Gunter

Practice Core Leader

Debbie A. Gunter, FNP-BC, ACHPN

Instructor

Emory School of Nursing

Rose Murphree, DNP, RN, CWOCN

Assistant Clinical Professor

Director, Wound, Ostomy, and Continence Nursing Education Center

Emory School of Nursing

John R. Worth, Jr. CPA, MBA

Associate Dean for Finance and Administration

Emory School of Nursing

Advisory Board

Paul Root Wolpe, Ph.D.

Paul Root Wolpe, PhD

Asa Griggs Candler Professor of Bioethics
Director, EVP Academic Affairs & Provost

Director, Center for Ethics

Emory University

Tammie Quest, MD

Tammie E. Quest, MD

Roxann Arnold Professor in Palliative Care

Director, Emory Palliative Care Center

Department of Emergency Medicine

Emory University School of Medicine

Marcia McDonnell Holstad, PhD, FNP-BC, FAANP, FAAN

Professor, Marcia Stanhope Professor in Public Health

Assistant Director of Clinical and Social Science Integration, Center for AIDS Research

Emory School of Nursing

Marilyn Margolis

Marilyn Margolis, MN, RN, NEA-BC

Chief Executive Officer

Emory Johns Creek Hospital

Emory University

Mary Beth Happ

Mary Beth Happ, PhD, RN, FGSA, FAAN

Associate Dean for Research and Innovation

Distinguished Professor of Critical Care Research

College of Nursing Center of Excellence in Critical and Complex Care

Columbus, OH

Sandra E. Ward

Sandra E. Ward, PhD, RN, FAAN

Professor Emerita

School of Nursing

University of Wisconsin-Madison

Madison, WI

Apply: Postdoctoral Fellowship

Priority deadline February 3, 2020

The Center for Nursing Excellence in Palliative Care at the Nell Hodgson Woodruff School of Nursing is seeking a stellar applicant to complete a two-year postdoctoral fellowship. All applicants must have or will have completed a PhD program by the start of the appointment. Applicants must demonstrate strong quantitative analytic skill.  The work will include assisting Center Director with research mentorship and leadership development for the Fuld Palliative Care Fellows (AMSN students) and other activities of the Center for Nursing Excellence in Palliative Care, implementation of Center Director's studies focused on end-of-life decision making and development and testing of palliative care interventions, including assistance with data analysis, abstract and manuscript preparation and assistance with the development of future grant applications. Because the post-doc position has the responsibility to participate in mentoring pre-docs and Fuld fellow students in palliative care, substantial previous exposure to palliative care practice and/or research is required.

Applicants should submit: 1) their letter of interest detailing their research, overall research goals, career goals, and expectations for how this traineeship will advance both sets of goals, and their next step in their program of research; 2) curriculum vitae; and 3) sample of writing (publications). They should arrange for the transcript from their doctoral program and provide the contact information for three letters of reference. Selected applicants will be invited to complete an interview with the Center Director.

Apply Now

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Contact information

Office: 404.778.4067
Fax: 404.778.4778
Email: enpdc@emory.edu