The course aims to provide students with knowledge and practical skills in nursing care for oncological and non-oncological patients requiring palliative care in end of life. It will explore aspects related to managing the needs of patients and their families in end of life, developing effective care interventions, and managing pharmacological and palliative therapies in this context.
At the end of the course, in accordance with the Dublin Descriptors, to pass the final examination, the student must demonstrate the following:
KNOWLEDGE AND UNDERSTANDING
By the end of the course, students will have acquired an understanding of the diagnostic, therapeutic, and care pathways related to major oncological and non-oncological conditions requiring palliative care in end of life. They will be able to manage drugs used in palliative care, having assimilated knowledge of their characteristics and methods of use. Additionally, they will be able to analyze the care needs of the patient and their family in end of life of oncological and non-oncological diseases, understanding how different symptomatological profiles evolve and impact the patient's quality of life and death.
ABILITY TO APPLY KNOWLEDGE AND UNDERSTANDING
Students will be able to apply the theoretical knowledge acquired in daily practice by designing and implementing supportive care interventions that consider the complexity of the patient's and family's needs especially in end of life. They will be capable of conducting accurate clinical assessments to identify the specific needs of oncological and non-oncological patients requiring palliative care in end of life, managing drug administration safely and effectively while adhering to care procedures. Furthermore, they will be able to plan and implement symptomatic treatments with a holistic and personalized approach aimed at improving patients' quality of life and death.
AUTONOMY OF JUDGMENT
By the end of the course, students will be able to independently assess the quality of life and death of patients and identify the most appropriate intervention strategies in this context. They will demonstrate the ability to make independent care decisions based on scientific evidence and recognized quality standards of end of life palliative care. Additionally, they will be prepared to recognize and manage emergencies in palliative care, adapting their clinical decisions to the immediate needs of the patient while respecting the dignity of the person being cared for.
COMMUNICATION SKILLS
Students will develop skills in effective communication with patients and their families, sensitively addressing delicate topics such as bereavement and care planning. They will be able to use symptom assessment tools and share complex information in a way that is understandable and accessible to patients and their loved ones. Furthermore, they will demonstrate the ability to collaborate with other healthcare professionals, promoting a multidisciplinary and integrated approach to palliative and end of life care, which is essential for ensuring comprehensive and personalized care.
ABILITY TO LEARN
Students will be able to continue developing their knowledge and skills independently, recognizing the importance of continuous updates on new scientific evidence and guidelines in palliative care. They will be capable of actively participating in training and refresher courses, aware that continuing education is essential to maintaining high standards of care. Finally, they will demonstrate the ability to critically reflect on their clinical practices, using feedback to continually improve their care competencies and provide increasingly effective and compassionate service to patients.

Basic competences of first year of Nursing School

End of life care

•Oxford Textbook of Palliative Medicine (6 edn) Nathan I. Cherny (ed.), Marie T. Fallon (ed.), Stein Kaasa (ed.), Russell K. Portenoy (ed.), David C. Currow (ed.). August 2021
•Manuale di Medicina e Cure Palliative. Augusto Caraceni, Raffaella Antonione, Simone Veronese, Marco Maltoni. Novembre 2024.
•Sallnow L et al. Report of the Lancet Commission on the Value of Death: bringing death back into life. The Lancet Commissions. Published Online January 31, 2022, https://doi.org/10.1016/S0140-6736(21)02314-X
•Building Integrated Palliative Care Programs and Services. Edited by Xavier Gómez-Batiste & Stephen Connor. 2017
•Sobanski PZ et al. Palliative care for people living with heart failure: European Association for Palliative Care Task Force expert position statement. Cardiovascular Research (2020) 116, 12–27.
•Comitato Nazionale di Bioetica. Definition of life support treatments. https://bioetica.governo.it/media/titp0sf3/risposta-tsv-rev-2-luglio-2024-finale.pdf
•Law 38/2010 Ministry of Health
•Law 219/17: Norme in materia di Consenso Informato e Disposizioni anticipate di Trattamento. (Advanced care planning and informed consent)
•Farmaci off-label in cure palliative (CP) per la popolazione adulta. AIFA (2018) (Off-label drugs in the adult population in palliative care)
•Linee guida sulla sedazione palliativa nell’adulto 2023 (SIAARTI-SICP; ISS) (Palliative sedation guidelines)
•Global Atlas of Palliative Care; 2nd edition (2020)
Palliative Care Nursing: Quality Care to the End of Life. Catherine Walshe, Nancy Preston, Bridget Johnston Open University Press 2018, Third edition

Main topics:
- Principles and basics of Palliative Care
- History of Palliative Care
Identification of active dying process
- Nursing in palliative care and in end-of-life care
- Nursing Core compétences in palliative care
- From "cure" to "care": embracing the patient and the family
- Care settings in palliative medicine (hospital, home, nursing home, Hospice).
- Psychological and comunication issues in end of life.
- Symptoms in end-of-life (Pain, dyspnea, delirium). Clinical and nursing approach
- Palliative sedation
- Hydration and nutrition in end of life

Front classes, group discussions and brainstorming, individual or group work on real clinical situations. All lessons will encourage student-teacher interaction and multidisciplinary approach (medical doctor, nurse).

Students are invited to study from advised texts. On request, literature will be given to each student on individual basis and on personal preferences.

Through a practical/oral exam with open questions lasting approximately 15 minutes, on the topics covered in the course. The rating will be: approved or not approved. The exam is intended to be approved if the student demonstrates adequate knowledge and reasoning skills.

This course explores topics closely related to one or more goals of the United Nations 2030 Agenda for Sustainable Development (SDGs)