Table of Contents

Preface
Acknowledgments
List of Contributors

Section I The Palliative APRN
1 Palliative APRN Practice and Leadership: Past, Present, and Future
Constance Dahlin and Patrick J. Coyne

2 Fundamental Skills and Education for the Generalist and Specialist Palliative APRN
Dorothy Wholihan, Charles Tilley, and Adrienne Rudden

3 Credentialing, Certification, and Scope of Practice Issues for the Palliative APRN
Kerstin Lea Lappen, Matthew McGraw, and Kate Meyer

Section II Palliative APRN Roles
4 The Palliative APRN in Administration
Karen Mulvihill

5 The Palliative APRN in Nursing Education
Carrie L. Cormack and Kathleen O. Lindell

6 The Palliative APRN in Policy and Payment Models
Marian Grant

7 The Palliative APRN in Research and Evidence-Based Practice
Janice Linton and Joan G. Carpenter

Section III Clinical Settings of Palliative APRNs
8 The Palliative APRN in the Medical, Surgical, and Geriatrics Patient Care Unit
Phyllis B. Whitehead and Carolyn White

9 The Palliative APRN in the Intensive Care Setting
Clareen Wiencek

10 The Palliative APRN in the Emergency Department
Sarah Loschiavo and Angela Starkweather

11 The Palliative APRN in the Palliative Care Clinic
Brooke Smith and Lisa A. Stephens

12 The Palliative APRN in Primary Care
Rosemary Gorman, Dorothy Wholihan, and Sarah Bender

13 The Palliative APRN in Specialty Cardiology
Beth Fahlberg, Ann Laramee, and Erin Donaho

14 The Palliative APRN in the Community Setting
Nicole DePace

15 The Palliative and Hospice APRN in Hospice and Home Health Programs
Rikki N. Hooper, Chari Price, and Jamie Lee Rouse

16 The Palliative APRN in Rehabilitation
Lorie Resendes Trainor

17 The Palliative APRN in Telehealth
Katherine Kyle and Constance Dahlin

18 The Palliative APRN in the Rural Community
Traci Sickich

19 The Palliative APRN in Residential Facilities
Melissa McClean and Victoria Nalls

Section IV Populations at Risk
20 Health Disparities in Palliative Care and Social Determinants of Health
Alma Y. Dixon and Cecilia R. Motschenbacher

21 Economically Disadvantaged Urban Dwellers
Natasha Curry

22 Inclusive Palliative Care within the LGBTQ+ Community
Jessica Nymeyer

23 Care of Veterans with Palliative Care Needs
Alice C. Foy, Robert David Rice, and Joseph Albert Melocoton

24 Recurrent Disease and Long-Term Survivorship
Denice Economou and Brittany Bradford

Section V Pediatric Palliative Care
25 The Pediatric Palliative APRN
Cheryl Ann Thaxton and Nicole Sartor

26 The Pediatric Palliative APRN in the Acute Care Setting
Faith Kinnear and Gina Santucci

27 The Pediatric Palliative APRN in Perinatal and Neonatal Palliative Care
Maggie C. Root and Mallory Fossa

28 The Pediatric Palliative APRN in the Clinic
Alice Bass and Vanessa Battista

29 The Pediatric Palliative APRN in Oncology
Amy Corey Haskamp and Joanne M. Greene

30 The Pediatric Palliative APRN in the Community
Joan "Jody" Chrastek and Jaime Hensel

31 Communication in Pediatric Palliative Care
Mallory Fossa, Julia McBee, and Rachel Rusch

Section VI Communication in Palliative Care
32 Advance Care Planning: Advance Directives, Medical Order Sets, and Surrogate Decision-Making
Hannah N. Farfour

33 Family Meetings
Jennifer Gentry, Kerrith McDowell, and Paula McKinzie

34 Communication at the End of Life
Marlene E. McHugh, Penelope R. Buschman, and Susan M. Delisle

Section VII Psychosocial, Cultural, and Spiritual Aspects of Care
35 Culturally Respectful Palliative Care
Helen Foley and Polly Mazanec

36 Ensuring Quality Spiritual Care
Betty Ferrell

37 Life Review
Jamil Davis, Mimi Jenko, and James C. Pace

38 Grief and Bereavement
Katharine Adelstein and Elizabeth Archer-Nanda

Section VIII Symptoms
39 Anorexia and Cachexia
Robert Smeltz and Renata Shabin

40 Bowel Symptoms
Kimberly Chow and Lauren Koranteng

41 Fatigue
Shila Pandey

42 Nausea and Vomiting
Katherine E. DeMarco

43 Pain
Judith A. Paice

44 Respiratory Symptoms
Ember S. Moore and Kathleen Broglio

45 Cognitive Impairment
Abraham A. Brody and Donna E. McCabe

46 Serious Mental Illness
Kristyn Pellecchia and Ryan Murphy

47 Patients with Substance Use Disorders and Dual Diagnoses
Jeannine M. Brant and Tonya Edwards

48 Anxiety
Kira Stalhandske

49 Delirium
Bonnie D. Evans and Erica J. Hickey

50 Depression and Suicide
John Chovan

51 Palliative Emergencies
Ann Quinn Syrett, Marcia J. Buckley, and Beth Carlson

52 Challenging Symptoms: Pruritus, Hiccups, Dry Mouth, Fevers, and Sleep Disorders
Barton T. Bobb and Devon S. Wojcikewych

Section IX Ethical Considerations
53 Navigating Ethical Dilemmas
Nessa Coyle and Timothy W. Kirk

54 Discontinuation of Cardiac Therapies
Patricia Maani Fogelman and Janine A. Gerringer

55 Discontinuation of Respiratory Therapies
Brenna Winn

56 Discontinuation of Other Life-Sustaining Therapies
Kathy Plakovic and Jennifer Donoghue

57 Palliative Sedation
David Collett and Kelly Baxter

Appendix I Palliative APRN Billing and Coding
Constance Dahlin

Appendix II Perinatal and Pediatric Pain and Symptom Tables
Constance Dahlin, Amy Corey Haskamp, Joanne Greene, Maggie Root, Mallory Fossa, Faith Kinnear, Alice Bass, Nicole Sarter, Gina Santucci, Cheryl Thaxton, Jaime Hensel, Jody Chrastek, and Vanessa Battista

Index

About the Author

Constance Dahlin, MSN, ANP-BC, ACHPN®, FPCN, FAAN is a palliative care clinician, educator, author, consultant, and leader. She received her Master in the Science of Nursing in Oncology Nursing and her Post- Master's Certificate in Adult Primary Care at the MGH Institute of Health Professions. Ms. Dahlin is a Fellow of the American Academy of Nursing, and a Fellow of Hospice and Palliative Nursing. She was the 2011 NBCHPN - Certified ACHPN of
the Year, a 2016 recipient of a Cambia Health Foundation Sojourns Scholar Award and the 2020 HPNA Distinguished Nursing Practice Award. She was named a 2018 Visionary in Hospice and Palliative Medicine. She has served on
various national committees and workgroups, authored peer reviewed articles, chapters, and curricula as well as presented nationally and internationally.

Patrick J. Coyne, MSN, ACNS-BC, ACHPN, FAAN, FPCN is Clinical Nurse Specialist, Assistant Professor, and Director for Palliative Care at the Medical University of South Carolina in Charleston, SC, a Circle of Life awarded program. He developed and oversees an interdisciplinary team of health care professionals in providing exceptional palliative care. Mr. Coyne serves as a member of institution's Medical and Nursing faculty. Previously, he was clinical director of the
Virginia Commonwealth University Massey Cancer Palliative Care Service where he developed an inpatient unit and worked on state-wide initiatives to improve palliative care. Mr. Coyne served on the National Board for
Certification of Hospice and Palliative Nurses and the Hospice and Palliative Nurses Association. He is Co-PI for several grants to educate rural and community APRNs and health providers on primary palliative care. Mr. Coyne serves on the national and international faculty of the End-of-Life Nursing Education Curriculum (ELNEC). He has published over a hundred articles related to pain management, symptom control, and issues in end-stage disease as well as conducting research studies. Mr. Coyne
has received the Peaceful Death in American and Mayday Pain and Society Scholarships and has been awarded the Oncology Nursing Society's Excellence in Pain Management and a Schering Lectureship
Recipient. He was named one of the 30 Visionaries in the field by the American Academy of Hospice and Palliative Medicine in 2013. Mr. Coyne has worked diligently to improve pain management and palliative care nationally and internationally.