Author: Casey Ryan, C’95
Penn Nursing has a proud 125-year legacy. Since 1886, nursing education at Penn has transformed the preparation of nurses and the profession of nursing. Many of the early nurses educated at the Hospital of the University of Pennsylvania and other programs truly changed the world. They managed hospitals and brought clean uniforms, order, and dignity to healthcare, changing the way society viewed nurses and, in the process, turning nursing into a respected and sought-after profession. Today’s nursing students build on that robust foundation as they work with world-renowned faculty to generate new knowledge in research and forward advances in clinical care. These students join approximately 14,000 alumni from the HUP School of Nursing, Penn’s nursing education programs, and the current Penn School of Nursing. Each one of these students and alumni is caring to change the world through their efforts as practitioners, educators, researchers, community leaders, administrators, and policy advocates.
This year for the annual Penn–Cornell Luncheon, the Penn Club of Rochester hosted Dr. Mary Ersek, Associate Director, Center for Integrative Science in Aging and the John A. Hartford Center of Geriatric Nursing Excellence, and Associate Professor at the University of Pennsylvania School of Nursing. Her presence at the traditional event highlighted our outstanding Nursing School’s Quasquicentennial. This annual luncheon between the two school’s alumni clubs in Rochester has been going on for over 70 years. Originally the gathering served as an affair for the two clubs to get together before the Penn-Cornell football game, which was originally played on Thanksgiving. The luncheon, now held the Monday before Thanksgiving, serves as regional institution with the heart of the event being the keynote speaker who hails from hosting alumni club’s school. Today, the hosting responsibilities alternate between the University alumni clubs, based on whether Penn or Cornell is the home team that year.
Dr. Ersek’s address was titled “It is Your Life, Anyway: Healthcare Decision-Making in the context of Serious Illness,” which she delivered as an engaging and encouraging approach to palliative care. The talk introduced the specialized area of healthcare that is both family-centered and focused on relieving and preventing the suffering of patients to the attendees. Unlike hospice care, palliative medicine is appropriate for patients in all disease stages, including those undergoing treatment for curable illnesses and those living with chronic diseases, as well as patients who are nearing the end of life. This type of care involves addressing physical, intellectual, emotional, social and spiritual needs and to facilitate patient autonomy, access to information and choices.
Though a heavy topic, Dr. Ersek delivered a genuine talk about the importance of having choices in one’s treatment, gaining the adequate information about those choices as well as learning that information from an appropriate health care provider, having conversations with both health care provider and family in light of the options, and finally making the decisions and communicating them successfully to all involved. She focused heavily on having the conversation, since this is the most difficult part in the process. Insightfully, she relayed anecdotes from her nursing students to demonstrate how to broach the subject. In class, Dr. Ersek would show a clip from 2007’s The Savages featuring Laura Linney, Philip Seymour Hoffman, and Philip Bosco having the difficult discussion as two children discovering their father’s ideas for care. The scene is humorously awkward, but in the end provided her students with the means to be open to having this discussion with future patients as well as with their parents and future health care proxies.
Pennsylvanians and Cornellians alike left the luncheon appreciating the field of palliative care. They noted in passing that they need to be open to talk about end of life care before it should be of any concern. While not talking about it, any insured person will be given all life-sustaining therapies. However, this may not be in the individual’s own needs. The best time to discuss this topic is while one is still able to establish her or her own definition of quality of life.
Dr. Mary Ersek directs the palliative care minor in the School of Nursing and teaches in courses in this program. She also mentors pre- and post-doctoral fellows and students and is the lead author of the End-of-Life Nursing Education Consortium (ELNEC) Geriatric curriculum. Dr. Ersek’s research centers on pain and palliative care in older adults, with an emphasis on residents of nursing homes, including the investigation of the efficacy of a pain self management group for residents and the examination of the effectiveness of a pain management coupled with intensive support and consultation.
Dr. Ersek referenced the New Yorker article, “Letting Go: What should medicine do when it can’t save your life?” by Atul Gawande. It is a very powerful read, accentuating many of Dr Ersek’s themes and points.