Latina Nurse Practitioner Bridges Gaps in Care for Patients With Hospice and Palliative Care Needs
Read the powerful story of one nurse practitioner, professional friend and quality-of-life navigator that's striving to provide person-centered care.
Observed from September 15 – October 15, National Hispanic Heritage Month celebrates the contributions of more than 63 million
Hispanic and Latino people living in the U.S. October is also home to other important observances, including World Hospice and Palliative Care Day. In honor of these observances, read on to hear from Elena Prendergast, DNP, APRN, FNP-C, ACHPN, a Latina leader, clinician and educator with a passion for palliative care, and learn how you can improve comfort and quality-of-life care for your patients.
Seeing the Patient in the Provider
It is commonly understood that when a patient interacts with a health care provider who they are comfortable talking to or can easily identify with, the patient is more likely to have a positive outcome. However, not everyone has an equal chance to see someone of their racial and ethnic background when seeking care. According to the Centers for Disease Control and Prevention (CDC), “Hispanic or Latino people in the U.S. are underrepresented in health care and related health fields and face challenges to receiving the post-secondary education and training needed to enter these fields.”
Prendergast recounted how these challenges were laid out in front of her at an early age. “My father came from Puerto Rico to this country. He was a huge baseball fan, and one of the things he used to say was, ‘You have two strikes. One, you're a woman. Two, you're Puerto Rican.’ And he said, ‘When you come up to the plate, you have to decide: Are you going to strike out or are you gonna knock it out of the park?’"
Like many other Hispanic/Latino Americans, Prendergast had to set her own course for success through territory foreign to her family. “As a first-generation college graduate, I have probably achieved well over what [my father] wanted. What I hope to do is serve as a role model for others who are underrepresented, especially in our fields, and say, ‘Don’t let those barriers get in your way, but decide what your goals are and then you set the role.’ I heard a quote today: ‘It’s not where you sit at the table, it’s actually what you do when you sit at the table.’” AANP empowers all NPs to follow in Prendergast’s footsteps and advance high-quality, equitable health care — while addressing health disparities — through practice, education, advocacy, research and leadership. Learn more about AANP’s commitment to diversity today.
Discovering the Call for Care
Though she is now known for her work as nurse practitioner (NP) working in palliative care, Prendergast was initially dissuaded from pursuing work in a health or scientific field. “In seventh grade, I was told, ‘Don't go into science, because you'll probably starve.’ I've told that story to different people, and they all sit there shocked. I let that become part of my story and stayed away from science and anything to do with it.” Instead, she pursued a wide variety of careers prior to beginning her nursing journey. “I didn't come into nursing until I was 40 years old. I had done real estate, security, administrative assistant, military, military spouse […] I had been in nursing probably about four or five years when I discovered the specialty of palliative care and decided that was what I felt I was called to do.”
What caused Prendergast to make such a dramatic change in her career? “Unfortunately, I had multiple miscarriages. I had never experienced a loss and I didn't know what to do with that. When you combine a military life, multiple losses and feeling like I couldn't do anything that I thought I could do, it finally came a point in my life where I was confronted with the question of, ‘Who are you?’”
With the support of her family, she went on to set the example for others like herself. “I wanted [my daughters] to realize that, regardless of whatever choices you made in life, it's never too late to be what you could have been. Somehow, my mother believed that I could have been a nurse and tried to impart that to me. I wanted to set an example to them and to the future generation that age does not define us.”
After all this time, Prendergast reflects on her current role with pride. “I am a professional friend and professional advocate. I hope to be the person that someone feels can sit right next to them, have coffee and talk about what's going on in their lives — whether it's their health, family or community problems — and feel that I truly am invested in them.” Creating a positive and friendly environment for patients enables her to get the information she needs to coordinate care across the health care team. “What I tell people is: I'm the person who comes into the room, I ask you who you are and what's important to you, and I take the time to listen. But then, I put on that white coat, walk into the other room and talk to everybody else who has white coats on and ensure that they listen to you.”
Navigating Quality-of-Life Through Palliative Care
“When you think about palliative care, most people think about end-of-life hospice. I think of it more as supportive care,” stated Prendergast. On average, Hispanic/Latino Americans are likely to live 1.3 years longer than their non-Hispanic white counterparts. Despite their longer lifespan, CDC data shows that in 2022 approximately 16% of Hispanic/Latino adults were in fair or poor health, compared to 13.5% of non-Hispanic white adults. This can lead to complications for aging Hispanic/Latino populations that require more support in the palliative care environment.
When asked to define her role in palliative care, Prendergast explained: “I call myself a quality-of-life navigator when I'm talking to patients, families and even in the community. Part of that quality of life is realizing what drives us and what most of us want.” In this regard, NPs working in palliative care operate on the same principles of person-centered care as those working in primary and acute care settings. “My passion is about making sure that we define and then help our families and our patients achieve quality of life. Regardless of whatever diagnosis your patients have, they want and deserve that. I think NPs are really the best ones to help them achieve it.”
Channeling her connection to patients and her own experiences with loss, Prendergast focuses on providing patients with what they need. “I remember one instance where this man's time was very limited, and all he kept saying is, ‘I just want to lay next to my wife. We've been married over 50 years,’ and we were able to work together to make sure that we fulfilled that wish for him.” This approach also aids in the recovery of patients who aren’t at end-of-life. Prendergast recounts another patient’s story, where “I was able to sit down and determine that they had no children or anyone that was of significance to them, but their pets were. I had to advocate with the team to say, ‘This is what's going to improve quality of life and the recovery process for this patient.’ There are so many instances like that where you bring a smile to somebody's face, and you bring them hope and meaning in their recovery. That's what I love about what I do.”
Engage, Learn, Network and Progress Practice in Hospice and Palliative Care
Do you want to help observe World Hospice and Palliative Care Day? The Hospice and Palliative Care AANP Community offers a unique opportunity to interactively collaborate with colleagues who share interest or clinical expertise in hospice and palliative care.
As a community member, you’ll have access to a cutting-edge, online forum where you can engage in discussions, document sharing and knowledge exchange with fellow NPs. Come learn, share and help progress the development of theory and practice in hospice and palliative care by joining this AANP Community today.