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The Pain and Palliative Care (PPC) Service of the Department of Medicine offers a one-year clinical nurse fellowship to master's prepared nurse practitioners. The nurse practitioner fellowship program is integrated with the MD fellowship training program. At the end of the training the nurse practitioner will be prepared to sit for the advanced certification examination in palliative and hospice nursing offered through the Hospice and Palliative Nurses Association.
The purpose of the Pain and Palliative Care Nursing Fellowship is to train qualified nurse practitioners to function as clinical experts in pain management and palliative care. The focus of training is in the development of expertise in:
- Assessment and management of pain syndromes associated with cancer and its therapy in collaboration with other members of the interdisciplinary pain and palliative care team
- Assessment and management of non-pain symptoms associated with cancer and other life-threatening illnesses in collaboration with other members of the interdisciplinary pain and palliative care team
- Assessment and management of psychosocial complications of cancer and other life-threatening illnesses in collaboration with other members of the interdisciplinary pain and palliative care team
- Basic principles and practical applications of medical and nursing ethics and legal aspects of pain management and palliative care
- Spiritual, religious, and existential aspects of care
- Cultural aspects of care
- Advanced care planning
- Continuity of care through liaison and coordination with community agencies and healthcare professionals
- Care of the imminently dying patient and his or her family
- Grief, loss, and bereavement
- Collaborating with interdisciplinary pain and palliative care researchers
During the first year, trainees rotate through the inpatient PPC Consultation Service, which sees approximately 40 to 60 consultations per month and is managed with daily involvement by the attending staff. The trainee also rotates through the inpatient PPC Unit, where acute palliative care is provided to patients with cancer and other life-threatening illnesses. In the PPC Ambulatory Clinic, the fellow sees patients with the attending physicians. These patients are referred from the inpatient PPC Consultation Service.
The nurse fellow also has the opportunity for observerships and rotations with the Department of Psychiatry and Behavioral Medicine, the Department of Integrative Medicine, and the Department of Anesthesiology and Critical Care Medicine's Pain Service. In addition, an extramural rotation at Calvary Hospital, a facility for terminally ill cancer patients, and the Visiting Nurse Service of New York's Hospice program is available. These opportunities allow the nurse fellow to supplement his or her education with exposure to different healthcare services and environments with a diversity of patient populations. Other electives can be arranged on an individual basis.
The trainees will participate in the weekly teaching and conference activities of the PPC Service in addition to attending the weekly PPC Grand Rounds and Medicine Grand Rounds at Memorial Sloan-Kettering. The trainee is responsible for presenting clinical cases at the PPC Service's daily multidisciplinary rounds, as well as at the weekly PPC Multidisciplinary Service Meeting. Didactic sessions are held throughout the year on a wide variety of topics related to pain management and palliative care. Each fellow is required to complete scholarly work by the end of the program. This includes but is not limited to conducting a journal club presentation, preparing and delivering a talk for the weekly fellows' conference, and giving a presentation at PPC Grand Rounds. Fellows are encouraged to participate in a research project of their choice with mentorship from one of a member of the PPC faculty.
Mary Layman-Goldstein, NP
Nurse practitioners on the Pain and Palliative Care Service, both inpatient and outpatient, will provide mentorship and clinical guidance. These nurse practitioners are Lorraine Anderson, Kimberly Chow, Susan Derby, Mary Layman-Goldstein, and Joan Pope.