Bridging the gap in end-of-life care education

Feature Stories | 14 May 2025 | Read time: 5+ min

Queen’s nursing students are leading a project to bring more compassion and clarity to how end-of-life care is taught.

“It wasn’t something I felt ready for.”

It might be an expected occurrence on a palliative care floor, or it may happen suddenly, without warning in an emergency room. Sometimes, it occurs in a quieter care setting, when an unexpected code is called for a patient no one thought was declining.

No matter what the situation, there’s no perfect protocol for what follows someone’s final breath. Patient death and end-of-life care can be one of the most emotionally and ethically challenging aspects of nursing. Yet many nurses first experience this difficult situation in the clinical setting, before they even graduate. While nursing education covers the principles of end-of-life care (EOLC), it doesn’t always prepare students for the emotional weight of witnessing death firsthand in the workplace. Many nurses have reported feeling unprepared for this inevitable experience, and the complicated emotions that can come afterwards.

Not something you can learn from a textbook

Last spring, Queen’s BNSc students Cassie Wilson and Katie Browne were in clinical when a patient on their floor passed away unexpectedly. The patient had been relatively stable beforehand, and the experience stayed with them.

“It was pretty tough,” explains Cassie, who witnessed the patient code. “We didn't really feel prepared for handling it in the moment, or for how to take care of ourselves afterwards.”

“It doesn't really mirror anything we’ve prepared for as [nursing] students,” adds Katie. “You go home and think, ‘that’s what I saw at work today’. How do you practice self-care and process that?”

Both students credit their clinical instructor for providing a thorough and supportive debrief afterward, but they acknowledge this may not be the universal learner experience. Not everyone is comfortable talking about death, and there didn’t seem to be many school resources or supports designed to help in situations like this.

It was a gap in their education that felt too big to ignore.

“The clinical team's compassion and care for this patient was really phenomenal,” says Cassie. “They did such an incredible job. But this was not something I felt ready for, personally or in my education. We kept coming back to the question: how can we support and prepare students before an event like this happens?”

That question became the foundation of their student-led initiative: Navigating End-of-Life Care: Bridging the Educational Gap. Now, with faculty mentorship and overwhelming peer-support, it is currently being adopted into Queen’s School of Nursing curriculum.

students sitting in tiered rows of lecture hall seats, backs to the camera, facing a panel of nursing experts sitting on stage in a row

The video launch event brought students and experts
together for conversation, reflection, and change.

Changing what comes next

Cassie and Katie brought their concept to their program’s clinical lead, Marnie Chapman, and faculty member Dr. Katie Goldie. One idea stood out: a video resource for nursing students that acknowledged the emotional realities of EOLC and supported provider well-being. Something that could increase student comfort and confidence, while creating avenues for open conversation early in their education.

That idea was handed to a team of students in NURS 405, a practicum course focused on health promotion strategies. Brooke Stegehuis, Samantha Netherton, and Ryleigh Tabbert led the first phase of development, gathering the initial student data and producing the final video.

Findings revealed that while half of Queen’s nursing students had encountered death or grieving families during clinical placements, most felt unprepared to navigate these conversations. Many learners wanted something to help them manage both the clinical and emotional aspects of the experience.

When Cassie and Katie enrolled in NURS 405 the following semester, it felt like a natural next step to continue the project. They joined forces with fellow BNSc student Aileen Gencturk to build on the previous group’s work.

“The first time I saw a death in clinical, I didn't really know what to do. This project was about equipping students face those moments with more preparation and less fear, dispelling some of the stigma,” says Aileen.

Together, the group’s focus became curriculum integration. Their goal is to embed EOLC education across multiple courses. Not just in one lecture or clinical rotation but in touchpoints throughout the education journey.

Using the video as a starting point, the student group planned a launch event for the resource, bringing in a panel of EOLC nursing experts, and collecting feedback from attendees. The faculty and student response has been overwhelmingly positive.

“We know from our research that students in many different health professional programs do not feel confident approaching end-of-life care and everything that goes along with it,” says Aileen. “Having our peers tell us the video helped them feel more confident was such a meaningful outcome.”

The group has also submitted formal curriculum recommendations to their program. These include integrating the video into labs, expanding simulation-based debriefs, and introducing EOLC content earlier and more consistently.

Group photo of Katie Goldie, Katie Browne, Cassie Wilson, Aileen Gencturk and Marnie Chapmen smiling at the camera

Katie Goldie, Katie Browne, Cassie Wilson, Aileen Gencturk
& Marnie Chapman after the event panel for nursing students.

One simulation update is already in place: a resuscitation scenario that now ends in an unavoidable patient death outcome. Instructors guide students through a reflective debrief that addresses both clinical actions and emotional responses. Plans are also underway to implement the video resource into a second year clinical course this fall, in a lab delivery format.

“Queen’s BNSc program is committed to fostering compassionate, competent practitioners who are prepared to meet the complex needs of individuals and families, including during end-of-life care,” says Marnie. “This initiative not only addresses a curricular gap, but it’s also a great example of how student-led work enhances our program. When students take ownership of their learning and are encouraged to identify gaps, offer solutions, and support one another, they become leaders.”

Cassie, Katie, and Aileen will present their work this June with Dr. Goldie at the Hospice Palliative Care Ontario conference, bringing their recommendations to a wider healthcare audience. The hope is by sharing the resource, maybe they can help shift the conversation around EOLC and create a stronger foundation for nursing students who come after them.

“Right now, our biggest focus is getting this project out there,” explains Katie. “Including to those in medicine and other allied health fields. People are looking for good end-of-life care resources—they’re looking for support. They know there’s a gap and they want to do better.”

Read time

5+ min

Bridging the gap in end-of-life care education

Queen’s nursing students are leading a project to bring more compassion and clarity to how end-of-life care is taught.

Not something you can learn from a textbook

Changing what comes next

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