It’s All About the Conversation

Our Mission:

to educate, advocate for, and empower Nebraskans
to engage in conversation about advance care planning
that includes goals of care and end of life care options across the life span

History and Plans:

“It’s All About the Conversation” was born out of an academic project at Creighton. As part of her practicum for her Masters of Science in Nursing, Helen Chapple worked with Blue Cross Blue Shield of Nebraska to gather interested people from all over Nebraska to talk about end of life issues in the state. Nebraska Hospice and Palliative Care Association had just completed their latest survey of state residents about their attitudes on the subject, and the timing seemed right. The first meeting occurred in Lincoln on April 3, 2012. Since that time a Steering Committee has formed to generate a mission statement and identify several projects of work. At present the Steering Committee has four task forces: Community Outreach, Clinician Training, Website, and State Fair. We enabled a clarification to be made to a Nebraska publication from the Department of Health and Human Services regarding Do Not Resuscitate orders. We have a small grant to investigate the impact of advance directives on the quality of dying, to gather information about Nebraska and its surrounding states in terms of legislation and regulations that affect end of life care, and to conduct several World Café Dialogues to explore what Nebraskans have to say about their care. We are also planning to have a booth at the Nebraska State Fair. The group has its headquarters at the Center for Health Policy and Ethics at Creighton University.

In General:

We are encouraging people to share their thoughts, fears, attitudes, and preferences regarding end of life and their goals for care. Our concerns include the lack of standardization in several areas that affect end of life care, including Out of Hospital DNR orders, and the requirement that hospice deaths at home receive a visit from the sheriff in most counties. We intend to discover the obstacles to achieving excellent care for dying patients in the state of Nebraska, whether that be the lack of opportunity to discuss one’s goals for care as conditions change, or an inconsistency in the ability of health care providers to respect those preferences when they are articulated. We admire the work of many mid-state providers in promoting the use of Physicians’ Orders for Life Sustaining Treatment (POLST) forms, and we continue to study the possibilities for expanding their use.

“It’s All About the Conversation” is an inclusive group. We invite participation from clinicians, community members, clergy, health care professionals, hospice and palliative care organizations, state employees, and anyone who shares our interests. If you are interested in receiving occasional e-mails about the progress of the group’s work, let us know, and we will add your name to our distribution list. If you are interested in becoming more actively involved, consider joining the Steering Committee, and we will put you to work on a project!

Since its January 2014 meeting, the Steering Committee of It’s All About the Conversation has obtained support from Nebraska State Emergency Medical

  • To work with Nebraska EMS toward revising Department of Health and Human Services Rules and Regulations to require a state-wide template for out of hospital DNR forms.
  • The acceptable template could take either of two forms: 1) the template now being used in Lancaster County or 2) the Physician’s Orders for Life Sustaining Treatment (POLST) form now being used in Columbus, Kearney, and Grand Island.
  • A requirement would be added that both the patient and the physician receive a copy of the completed form that carries both the patient and the physician signatures.