This outstanding program began in 2015 when a few CNIIIs in the Neuro ICU observed that nurses were not always comfortable, or they felt unprepared to care for patients at the end-of-life. These nurses led by, Louise Dowd RN and Yelena Libova RN, formed the Comfort Care Champions group.  The Comfort Care Champs are bedside nurses who have a passion for caring for the dying patient. They possess a passion for professional development in palliative care. They have additional education and training to provide primary palliative care and comfort care in the ICU setting. They have acquired skills to address all the domains of palliative care, including communication, symptom assessment and management, and caring for the whole person and family during a hospitalization with a serious illness. Often, this encompasses the art and science of caring for someone in their last days to hours to minutes of life.  The Comfort Care Champs are considered resources and leaders in the Neuro ICU. Currently, there are 21 nurses who are designated Comfort Care Champs. 

The Comfort Care Champs complete training in communication about serious illness. They are comfortable eliciting the values and goals of the sickest patients. Their communication skills extend to advocating for and being involved in family meetings about goals of care. These nurses are experts at pausing and listening to patients and families. They understand how important it is to get to know the person in front of them so that they may advocate for care that aligns with their values. There are many stories about how one of these nurses changed the trajectory of care because they picked up on a subtle statement by a patient. Big and small meaningful discussions and actions are happening daily in Neuro ICU.

The Comfort Care Champs are required to take additional classes on symptom management and withdrawing life-sustaining therapies. These nurses provide exquisite symptom management and care to people during their final hours to days of life. The Comfort Care Champs often lead the interdisciplinary ICU Comfort Care Huddle and make valuable contributions to the plan to ensure it is in line with patient-centered goals. Attending physicians and APP colleagues express relief when a Comfort Care Champion is caring for their patients when they transition to comfort care. 

Caring for the seriously ill and dying takes an emotional toll. The Comfort Care Champions keep their eyes open for opportunities to support each other and themselves. The group practices active listening. They don’t offer advice unless it’s asked for, and they allow each person to process their emotions in a confidential environment. The meetings have an educational component, too. Often, a champ will present a case study, or they will review evidence-based practices that are relevant to caring for someone near the end-of-life. 

Lastly, it should be noted that the Comfort Care Champions are unique to the Neuro ICU. They serve as role models in providing comfort care for other critical care units at UCSF Health.  Wouldn’t it be wonderful if more nursing teams supported the patient and the nurse as holistically as the Comfort Care Champions?

The Comfort Care Champs are resources in the comfort care process for patients transitioning to end-of-life. They bring extensive knowledge and expertise to navigating the difficult process of end-of-life care. I have personally looked to them for their exceptional communication and leadership skills help them guide me toward providing the best care possible to patients and their families. They approach every situation with dignity and empathy, taking the time to listen to the concerns and needs of both the patient and their loved ones. In every patient’s transition to a comfort-focused path, there are delicate aspects of our job that require grace and understanding. Each of these nurses has navigated those circumstances with poise countless times. The Comfort Care Champs leaders have exemplary skills. We have been lucky to work alongside these nurses and have benefited from their guidance.

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It is with great pleasure that I write this recommendation for the Comfort Care Champion Group in the Neuro ICU.  Our unit frequently admits patients with sudden devastating neurological conditions which unfortunately lead to an untimely death.  Not only are our nurses faced with caring for these incredibly complex patients, but also supporting families in a time of crisis and heartbreak.  A group of dedicated nurses realized that there was a great need for education and support in nursing to help care for and advocate for patients and their families.  What has developed after realizing this need is a vital, dynamic, and dedicated group of nurses who put amazing time, effort, and love into supporting each other, our patients, and their families.  

We keep a list of the champions so that we can use SYNERGY in our patient care assignments. This has helped nurses to feel supported and empowered in caring for this challenging patient population.  Our champions feel passionate about comfort care and proactively reach out to not only nurses, but providers to help coordinate all aspects of care for patients and families.  

I couldn’t be prouder of the passion and dedication this group shows up with each and every day.  As a former member of the group, I can say that they truly have elevated the care and support for nurses and their families in these devastating cases.  They have highlighted and supported the importance of patients having a dignified death while surrounding family and nurses with compassion.  I am a better nurse for what they have taught me, and I know they will continue to elevate our practice here on the Neuro ICU.

I am writing in support of the nursing team leaders for the Neurosciences ICU Comfort Care Champions Program. This team of nurse champions recognized the special needs of our patients and their families and formed the program in 2015. I have directly witnessed the impact of our bedside nurses and their influence on helping our patients and families transition to end-of-life care, advocating for dying with dignity, and early involvement of palliative care services. There are numerous examples where they incorporated personal requests for families to honor their loved ones with spiritual rituals, favorite music, or just listening to families express their grief. Their expertise provides a source of education, counseling, and managing expectations. Our patient families have constant praise for our nurses who have helped them in their most difficult times. 

In addition, the Comfort Care Champions program provides critical support and training to our NICU nurses.  Our bedside nurses are trained to provide clinical care to support the critical care needs of our patients, and the transition to palliative care can be difficult and challenging. The Team is available to support our bedside nurses so they can continue to provide the highest level of care to our patients and families during these important transitions. Our Comfort Care Champions Team is a model for other nursing units and most serving of a DAISY Team Award.