Kirkpatrick seeks to establish clinic for end-of-life care
If you ask Mandy Boesch Kirkpatrick, PhD, BSN’05, conversations about end-of-life care need to begin far earlier than they often do. For both patients and health care providers.
“We’re so focused on saving lives that, often, talking about death is sort of taboo, and we’re still struggling to get comfortable with those conversations,” Kirkpatrick says.
Kirkpatrick, associate professor of nursing, has spent much of her career contemplating death and dying. Now, Kirkpatrick has been named a Brooks Scholar, with funding provided thanks to a donation from donor Ella Stradinger Brooks, PhD, BSN’81. The funding comes as part of the College of Nursing’s Center for Faculty, Innovation, Research and Education (FIRE), a virtual center for clinical nursing research improvement.
The Brooks gift will fund a portion of Kirkpatrick’s time as she works on her latest project. Alongside co-principal investigator Meghan Walker Potthoff, PhD, BSN’01, associate professor and holder of the Keough Family Endowed Chair in Nursing, Kirkpatrick is working to establish an interprofessional clinic at Creighton in which students and expert faculty from across disciplines will work with Nebraska patients on planning for the end of their lives.
Initially funded through the Dr. George F. Haddix President’s Faculty Research Fund, the project, called INTERACT, looks to bring together Creighton experts in law, dentistry, business and other disciplines to establish a clinic where students work with aging Nebraskans on advance care planning (ACP), in which patients make treatment decisions prior to a serious diagnosis.
In addition to Kirkpatrick and Potthoff, the team includes: Jennifer Jessen, EdD, BSN’04, assistant professor in the College of Nursing; Laurie Baedke, instructor in the Heider College of Business and director of Healthcare Leadership Programs; Cathy Fox, BSW’09, assistant professor of social work in the College of Arts and Sciences; Victoria Haneman, Frank J. Kellegher Professor of Trusts and Estates in the School of Law; and Beatriz Rodriguez, BSN’16, MPH’22, and current student Sydney Langlois, who serve as research assistants.
“When you envision your death, you probably aren’t thinking, ‘I would like to die in a hospital on a ventilator after rounds and rounds of CPR,’” Kirkpatrick says. “You’d want to die in a place that’s comfortable to you, surrounded by loved ones. And you’d want the people that you love to understand what your wishes are.”
The problem, Kirkpatrick says, is that most people don’t want to discuss scenarios like this until it’s too late. Kirkpatrick and her colleagues on the project have found that though 92% of Nebraskans want their treatment wishes to be known when they die, only 1-in-3 have documented what they want their end-of-life care to look like. Nebraskans, she says, are far more likely to engage in estate planning than advance health care planning.
Without that documentation, Kirkpatrick says, distraught loved ones are likely to tell health care providers to do whatever it takes to keep the patient alive, regardless of how it will impact the patient’s final moments.
So far, Kirkpatrick and the team have been holding focus groups, involving faculty and students on campus and aging Nebraskans affiliated with partner Omaha-area agencies, to uncover what advance care planning resources are already available to the aging population and identify programming needs at Creighton so that the University is equipped to handle the problem.
“These sessions have provided our team with rich qualitative data, which we are currently analyzing for themes and will use to guide the development of our INTERACT clinic intervention,” Kirkpatrick says. “In the proposed clinic, we hope students from across the University will have the chance to engage with faculty who are already experts in the areas of law, business and health care, and give them the opportunity to provide a community service, working with aging Nebraskans who will benefit from making these decisions early on.”