By Eric Nagourney

New York Times; Health Section (Tues, February 13, 2001)

Despite recent growth of the hospice field, intended to help the terminally ill die as peacefully as possible, most Americans still die in hospitals. Other studies had found that doctors often failed to tell patients' families about their options; now, a new report suggests that nurses, too, may play a role.

In the current issue of The Journal of Professional Nursing, researchers reported that more than half the nurses studied in a hospital setting said they never discussed hospice care with their patients.

And while most reported using some of techniques employed in hospices to relieve pain and anxiety, many said they lacked important knowledge about hospice and palliative care.

The study, conducted by researchers from Yale, the John D. Thompson Hospice Institute of Branford, Conn., and the V.A. Connecticut Healthcare System, involved 180 nurses in six hospitals in Connecticut. The results, they said, suggest that nursing programs need to do a better job of educating their students about hospice care.

Dr. Elizabeth Bradley, the study's principal investigator and an assistant professor of epidemiology and public health at Yale, said that part of the problem might come down to tradition. "There is an age- old history of the role of the nurse and the role of the physician," Dr. Bradley said. "The fact is, breaking bad news is probably something, generally, people have thought of as the physician's role."