Nursing Online for End-of-Life Care?, by Brenda Hearson RN

When I started nursing over thirty years ago, I never would have thought I would be nursing online, but here I am – a palliative care clinical nurse specialist with Canadian Virtual Hospice. Every day I help people across the country. In one morning I may consult with a nurse in Penticton seeking a second opinion about a complex pain issue, locate support services for a patient in Peterborough or help a family in Truro negotiate the challenges of deciding to care for a dying loved one at home.

Actually, I have my fingers and feet planted firmly in two realms of caring – virtually as a member of Canadian Virtual Hospice’s interdisciplinary clinical team and in-person with the Winnipeg Regional Health Authority Palliative Care Program’s consultation team. Whether virtually across the nation or face-to-face locally, I provide information and support about end-of-life care, loss and grief to individuals, families, and health care colleagues. I find each setting enriches the other.

At Virtual Hospice, I work with an extraordinary team of palliative care specialists, including physicians, a psychosocial consultant, spiritual care advisor and ethicists who together have more than 120 years of palliative care expertise. Collaborating in the virtual world was an adjustment at first, but we have developed a system of interdisciplinary teamwork that, well … works. Together we answer Ask a Professional questions, vet resources for Tools for Practice, write articles for the website, and provide strategic guidance on the direction and evolution of the website.

I’m particularly proud of our signature tool Ask a Professional where the public and health care professionals can ask questions about life-limiting illness, end-of-life care, loss and bereavement. As the clinical nurse specialist, I triage the questions and coordinate which team members will be involved in responding, contributing to and reviewing the answer. The answers are personal, evidence-informed and confidential and provided within 3 business days or less. While we receive some common questions, the range of questions overall is astounding. We may get a question from a wife struggling to live with the death of her husband 6 years ago or a physician in rural BC wondering about neuropathic pain that is difficult to control or someone living with a terminal illness overwhelmed by death anxiety or a pharmacist working in the North wondering about a particular medication delivery route. Interesting enough nurses submit the largest number of health care provider questions to Ask a Professional. Given the complexity of care at the end-of-life, it is understandable that many questions arise in clinical practice. For that reason, one of our goals is to support and build capacity in local teams.

It is very gratifying to help connect professionals and the public to quality information, care and resources and to support the provision of quality care whether on Vancouver’s north shore or in One Hundred Mile House. Nursing online is a great opportunity to provide information and support in an accessible, cost-efficient manner. For visitors to the Virtual Hospice it is a safe, anonymous place to browse for trustworthy, up-to-date information and ask questions 24/7 at no cost. A win-win.

Have you ever visited Canadian Virtual Hospice?


Brenda Hearson is a Clinical Nurse Specialist with Canadian Virtual Hospice and the Winnipeg Regional Health Authority Palliative Care Program. She is dedicated to palliative care education for patients, families and colleagues. Brenda’s interest in palliative care and the role of the family caregiver have been woven throughout her extensive career in community health nursing.

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Leanna Loy

Hi Brenda,

thanks for your post. Your work highlights yet another realm in which nurses provide care and information re: best practice.

I am a home care nurse in Vancouver and I am finding not only more palliative clients on my caseload, but more and more complex clients as well. My work is rewarding.

We are fortunate to have the support of our Vancouver Home Hospice team for palliative symptom management. However, it is also nice to see a resource such as the Canadian Virtual Hospice.

Notably, I appreciate your sections on Moral Distress, Grief (Health Care Workers and Family/Caregivers) and Dying Well. These are issues that are vitally important but not always addressed in my practice. These are the issues that I personally struggle the most with.

Thank you for the amazing work that you do.

I will be using the Canadian Virtual Hospice for myself and for my clients and their families as well.

Sandra Betker

Hello Brenda,

This is a truly unique nursing role, with the ability to reach everyone from coast to coast to coast! I can't help but think how valuable for community health nurses from across the country if you, or one of your colleagues, might submit an abstract for the upcoming Community Health Nurses of Canada national conference? It is taking place in Kelowna, BC, June 17-19, 2013. All conference information can be found on the CHNC website http://www.chnc.ca

Hearing more about the Canadian Virtual Hospice would be awesome!