Interview: Nursing Professor Ernest Lapierre on Death and Dying

Interview: Nursing Professor Ernest Lapierre on Death and Dying

LaPierreSchool of Nursing Assistant Professor Ernest Lapierre, PhD, joined the Norwich faculty in 2012 after a long association teaching at the School of Nursing at his alma mater Rutgers University, now known as the University of Medicine and Dentistry of New Jersey. An adult psych mental health nurse practitioner who also works in private practice, Lapierre teaches a raft of courses at Norwich, including Psychiatric Mental Health Nursing, Health Assessment, Nursing Informatics, and Family Center Nursing. A Vermont native, Lapierre entered college at a time when men weren’t welcomed into nursing programs. Cajoling authorities at Castleton State College allowed him to double major in secondary education and nursing. Associate degrees in hand, Lapierre briefly tried his hand in business, but found it boring. He took a job working in a Hartford, Conn., emergency room and says he knew then that nursing was what he wanted to do professionally. His active and varied academic and professional career includes a doctorate degree from the University of Alabama and stints as a Nurse Corp captain for the US Army National Guard. A hiker, skier and lover of classical music, he is active in the LGBT community. Last semester, we asked Lapierre about End of Life Issues, his popular and powerful course on death and dying.

What is the course about?

It covers the whole aspect of death and dying. While we have one class on the physiological responses to death and dying, we don’t focus on that. More the psychosocial interventions that students have to understand. Different cultures and how they handle death and dying. We include spirituality and get into some of the religions. We have a panel with a minister, a rabbi, and a Muslim cleric. The students, of course, get to ask questions and share thoughts about their own religions.

One of my students had a mother who died this semester during the course. She’s seen it as a good course to help her through that process. It was kind of ironic. We hadn’t planned on it. But it happened that way. You just sort of take it. Because that’s what you have to do with death and dying. Take whatever happens in the person’s life and consider it part of their life. Dying is that ending process. That’s what we use as our theoretical basis and philosophy.

How is the course designed?

We work from a somewhat palliative/hospice model. That’s the foundation. But we go off in other directions. How do atheists handle death and dying? We also work very strongly on caregivers and respite type care for them, including the family. We’re very much into that whole process of loved ones. By definition a family doesn’t have to be the traditional family. It’s whoever determines that they are the patient’s family. It doesn’t have to be relatives.

It is a hybrid course. Students meet in person, but we have a lot of classes online. It’s a lot of discussion boards: OK, so you’ve read this. Now how would you apply it? How would you take it out there and apply it to something that would be nursing care for this client and their families?

I’m prepared to teach my students to step out of the box and be creative. Nursing is an art and a science. And I want my students to never, ever forget the art part of it. To be creative and to not ever think, How am I going to meet this patient’s needs? How am I going to make their life as comfortable as possible right to the very end? Whatever it takes, you need to be prepared to do it. So that’s what I try to get them to accept.

It’s an obvious question, but it’d be nice to hear you answer: Why is it important for nursing students to take this course?

Nursing students think about the fact that we have to save lives. That’s what becomes hard with death and dying-you can’t always save everybody. You can’t prevent death. That’s what I try to get students prepared for. That it’s going to be inevitable. We bring in the aspect of children and saying goodbye, of being able to prepare for death and of not being able to prepare. The patient brought into the emergency room after a motorcycle accident, who hasn’t made it. Nobody in the family has been able to prepare. The nursing staff has to be able to help the family deal with that.

I’m really very clear to my nursing students that you don’t work and provide care in a silo. You are a team, and you’d better be. Have some support services like your friends on the floor that you talk to, because this is going to bother you. There’s no way it can’t. That’s why I think this course is important.

Do you think we prepare ourselves well as a culture for death?

I think we’re getting better at it. It’s not taboo to talk about it. It’s not the pink elephant sitting on the coffee table any longer. It’s there. I think health care providers have become much better. That’s why we have End of Life Issues as a required course for our nursing students at Norwich. It’s not a required course for all programs in nursing across the country. It oftentimes is an elective. But for our students it’s required, and I think it helps them to be more prepared for this kind of mystery. Nobody knows what happens to us when we die. But we do know what happens to us in that process of dying.

This sounds like a favorite course of yours. Is it?

It is. Being a psych nurse, I like odd stuff. So anything that’s a challenge, that helps change the world, that gives Norwich nursing students added value because they have this course, well then I am so happy to do that.

When I teach psych nursing, I know most of the students don’t want to be psych nurses. They want blood and guts, the ER, the ICU, maternity. They want to see babies being born. But I tell them you’re going to see psych nursing no matter where you work, just like with death and dying. If you work with kids, you’re still going to be hit with death and dying. If you work in the ER or ICU. You can’t get away from it. So it’s better to be prepared and not be blind-sided the first time you experience it. Many of the students have experienced a patient dying before they come into the course. They figure it out. But they wished they’d had the class first.

This interview was edited and condensed for length and clarity.