Simulating end-of-life scenarios in teaching nursing students care of the dying patient

When a student nurse asked instructors to develop a workshop for increasing communication skills in delivering "bad news" and to talk with patient and families concerning end-of-life issues, we turned to the theater literature as well as nursing. In an interdisciplinary effort, nursing collaborated with the drama department, and students role played together scenarios of dying patients and their families. Three published articles in the nursing literature were given to students in preparation for the workshop. A hospice nurse (a former nursing student) presented hospice care concepts the students later used in the scenarios. Drama students portrayed scenes from Shadow Box and Rabbit Hole for all to explore the depth of these issues. One scenario was written by a former nursing student of Navajo heritage. The class learned the significance of culture in end-of-life planning from a Navajo perspective. In another scenario involving breaking bad news, students approached "the patient" (played by a nursing student) to discuss his recent diagnoses of HIV/AIDS. Debriefing, led by faculty from the nursing and drama departments, took place after each simulation with nursing and drama students combined. An evaluation at the end of the day demonstrated that the time spent on this subject was a powerful learning experience for the students. "This was a meaningful day as I now think I can approach, give care to, and be with the dying patient." Another said, "This was one of the best classes of the nursing program."