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Talking about death with the help of 'Julia'

A nurse consoles a bereaved woman

‘Julia’ is a mannequin programmed to breathe, blink and stimulate various medical conditions.

She has been introduced to the University of Houston’s College of Nursing to offer specialized training in palliative care – physical and emotional support for those who are in the last months of their life.

The project was initiated to address the limited clinical opportunities nursing students can have to experience end-of-life conversations with patients, or talk with bereaved families about their loss.

"Nurses will tell you they don't feel confident or competent with this subject matter. That's an issue," said Cheryl Brohard, assistant professor and project director.

Talking to patients and their families about death is a conversation that no one wants to have, but that healthcare professionals often have to do. Julia helps simulate realistic experiences for nursing students to learn how to talk about bereavement with people more comfortably.

Funded by the Texas Higher Education Coordinating Board's Nursing Innovation Grant Program, this specialized training is believed to be a first-of-its-kind innovation used by collegiate nursing programs.

“When you walk through a patient's door, you never fully know what to expect," said nursing student Aashaqali Momin who has been studying at the nursing college with Julia. "I'd rather be anxious here, than be anxious out in the field. This is a valuable learning opportunity."

A student nurse works with hi-tech mannequin Julia, to learn how to reassure real-life patients who are dyingA student nurse offers comforts and reassurance to his patient ‘Julia’. Picture via University of Houston

At the University of Houston, the simulation lab is designed to replicate a home-like setting, with the goal of building students' confidence in communicating with dying patients. Students are told that ‘Julia’ has terminal lung cancer. Her husband, played by a College of Nursing staff member, is by her side.

The students are then taken through three end-of-life scenarios. Firstly, they talk to Julia about coming to terms with her recent diagnosis. Next, the student needs to manage symptoms and dispense medication as Julia’s health deteriorates. The final stage will be comforting Julia’s ‘husband’ after she has died.

Research shows that over 28 percent of all deaths in the United States occur in hospital with nurses in attendance. Cheryl Brohard says that it’s imperative that hospital-based nurses who provide direct care to these patients, are competent in palliative care and bereavement support.

“The more times we can experience these scenarios, the calmer we are able to feel” agrees nursing student, Vy Pham.

“How do we start the end of life conversation? It's one of the most needed requests from our hospital partners," said Kathryn Tart, dean of the College of Nursing.

“This research will not only educate our students, but it has far-reaching implications for the entire healthcare system.”

If you are coping with grief after the death of a loved one with a terminal illness, find out more about bereavement support and counselling organizations.

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