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NurseTim presents...

End-of-Life and Culture Simulation: Free Recording

St. Cloud State University, Department of Nursing Science
Victoria R. Hammer, EdD, MN, RN, CNE (
Susan E. Herm, MSN, RN, BC (
Katherine A. Koepke, MS, BSN, RN, CNHP (

In the Fall of 2012, faculty at St. Cloud State University's Department of Nursing Science had an interest in End-of-Life (EOL) Simulation, and this nursing program had a nursing science lab to accommodate simulation. Since the community had three main cultures of Christian Caucasian, Native American, and Islam Somali, faculty decided to create three EOL simulations for these cultures. The EOL simulations were incorporated into the classroom and an accompanying clinical course entitled Nursing Care of the Older Adult. Community members from these three cultures and inter-professional healthcare providers (a chaplain and a hospice nurse) were contacted to assist in developing three cultural authentic EOL scenarios for simulation that occurred 15 minutes before and after death.

The simulations were developed for baccalaureate nursing students and took place with 10-20 students per day on two consecutive days in December 2012, April 2013, and again in November 2013. The students were divided into groups of three to seven, given the objectives of the simulation, assigned to a cultural scenario, given classroom information about EOL, instructed to research information on EOL in the culture they were assigned and share it with their peers, and required to complete a discussion post of what they thought would be difficult in caring for a person at EOL. On the day of the simulation, three to four students in each cultural group were randomly assigned the nurses roles and the others were to take notes during simulation. The three simulated scenarios occurred one after the other and each scenario was followed by an hour debriefing session led by faculty; two hours were allowed for pre-briefing, simulation, debriefing, and next scene set-up. The cultural community members who assisted in scenario development and other community members recruited within the culture acted in the scenarios as well as inter-professional health care providers. Care was taken to make the scenes as real of possible including moulaging the manikins to appear mottled and providing culturally appropriate props for each scenario. The students' responses were that it seemed quite real. They had an opportunity to practice caring for the dying and their families, and they learned about the differences in cultural rituals and care at EOL. We encourage faculty to consider incorporating this approach in their respective curriculum with cultures in their communities.

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