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What if the key to reducing resistance to care isn't doing more, but approaching care differently? In this episode of HPNA Palliative Perspective, internationally recognized dementia care expert Teepa Snow, MS, OTR/L, FAOTA shares practical techniques for licensed practical nurses and nursing assistants that prioritize connection before providing care. From seeking permission and interpreting refusals to using body language, pacing, and creative storytelling, listeners will discover simple, actionable strategies that can improve comfort, trust, and communication across hospice, home care, and long-term care settings.
This episode is part of HPNA HOMES initiative, which provides dedicated support, education, and resources for hospice and palliative care licensed practical nurses and nursing assistants. The initiative is made possible through generous funding from the Hospice and Palliative Nurses Foundation (HPNF), with grant support from the Jack Buncher Foundation and the Y.C. Ho/Helen & Michael Chiang Foundation. Together, these efforts help strengthen the skills of frontline caregivers while improving quality of life for patients and families living with serious illness.
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Teepa Snow, MS, OTR/L, FAOTA, is an Occupational Therapist with over forty years of rich and varied clinical and academic experience. Her experiences led her to the development of the GEMS® States of Brain Change and the Positive Approach™ training strategies. Her company, Positive Approach to Care® (PAC), provides online and in-person education and products to support those living with brain change. She also co-founded the Snow Approach Foundation, a nonprofit organization based in Hillsborough, North Carolina. Teepa presents with extraordinary expertise and humor to audiences throughout the world.
Brett Snodgrass, DNP, FNP-C, ACHPN, FAANP, has been a board-certified Family Nurse Practitioner for 18 years, practicing in multiple settings. She received her DNP from University of Alabama – Huntsville. She is currently the Palliative Medicine System Director of Operations for the Baptist Healthcare System. She is also the president of BBS Health Education – where she creates and presents continuing education for healthcare providers. Brett is a nationally recognized healthcare speaker and nationally recognized pain management expert, working for more than 20 years with pain patients in a variety of settings. She is board certified with the American Association of Nurse Practitioners. She is also a Fellow of the American Association of Nurse Practitioners and certified as an Advanced Hospice and Palliative Care Nurse.
Advocacy doesn't begin in the legislature—it begins wherever nurses use their voices to improve care.
In this episode of Palliative Perspective, HPNA Advocacy Committee member Janelle Williamson MSN, NP-C, APRN, ACHPN, FPCN, and Kansas State Representative Melissa Oropeza DNP, APRN, NP-C, CGRN, join the conversation to explore how nurses can influence healthcare at every level. From sharing patient stories and engaging in professional organizations to testifying on legislation and serving in elected office, they discuss the many ways nurses can shape policy and advance the profession.
Together, they reflect on their own advocacy journeys, the leadership skills that grow from speaking up, and why nurses are uniquely qualified to inform healthcare decisions. The conversation also addresses a common challenge: many nurses don't see themselves as policy experts, despite being the clinicians closest to patients and families.
Whether you're attending your first advocacy event, participating in an HPNA Hill Day, or simply wondering where to begin, this episode offers practical insights and inspiration to help you discover where your voice can make a difference. Advocacy isn't reserved for a select few—it's a natural extension of nursing practice, and every nurse has a role to play. HPNA Advocacy
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Melissa Oropeza, DNP, APRN, NP-C, CGRN, is a board-certified Nurse Practitioner specializing in Gastroenterology at The University of Kansas Health System and a Kansas State Representative. With more than 27 years of healthcare experience, she has been a leader in advancing the role of Advanced Practice Providers and improving patient care through clinical practice, leadership, and advocacy.
Throughout her career, Dr. Oropeza has championed the nursing and advanced practice professions. She founded and served as the inaugural Chair of The University of Kansas Health System's Advanced Practice Providers (APP) Council, where she established professional recognition programs, created an APP endowment fund, and launched the institution's first APP Symposium. Her leadership has created lasting opportunities for professional development, recognition, and advocacy for advanced practice providers.
A nationally recognized healthcare advocate, Dr. Oropeza served on the Kansas State Board of Nursing and became the first actively practicing Nurse Practitioner elected to the Kansas House of Representatives in 2022. She currently serves as Chair of the Wyandotte-Leavenworth County Legislative Delegation and as Ranking Minority Member of the Kansas House Social Services Budget Committee, where she works to improve healthcare access, strengthen behavioral health services, and advance policies that support Kansas families and healthcare professionals.
In addition to her legislative service, Dr. Oropeza continues to provide direct patient care and mentor future healthcare leaders. She is a strong advocate for healthcare access, mental health, and patient-centered public policy. Her professional honors include the 2017 Kansas Nurse Practitioner Advocate Award and numerous leadership and service recognitions throughout her career. In 2026, she received the Legislative Leadership and Collaboration Award for Mental Health Advocacy, recognizing her commitment to building bipartisan solutions and improving mental health outcomes for Kansans.
Janelle Williamson, MSN, APRN, NP-C, ACHPN, FPCN, is a nurse practitioner with Palliative Medicine and Supportive Care at Stormont Vail Health in Topeka, Kansas. A nationally recognized leader in hospice and palliative care, she has held specialty certification in the field for nearly 15 years and was named a Fellow in Palliative Care Nursing in 2023—an honor recognizing significant contributions to the profession. She has been a strong advocate for improving access to palliative care across Kansas, helping lead efforts that established the state's Palliative Care and Quality of Life Advisory Council and contributing to Kansas' first five-year palliative care plan. Janelle also serves in leadership roles with the Kansas Advanced Practice Nurses Association and the Kansas Advanced Practice Nurses Association's Political Action Committee. She is passionate about advancing hospice and palliative care while advocating for APRNs to practice to the full extent of their education and training.
For many nurses, retirement marks not the end of a career, but the beginning of a new chapter of service. In this episode, former HPNA CEO Judy Lentz, PhD, RN, reflects on how retirement created an opportunity to reimagine her role in palliative care through volunteer leadership and the development of palliative care ministry within faith communities.
Drawing on decades of experience in clinical practice, education, research, and organizational leadership, Judy explores how retired nurses and other healthcare professionals can continue to improve quality of life by supporting individuals and families living with serious illness. She also discusses the concept of the palliative care doula as one model for companioning individuals and families through serious illness, alongside practical examples of how congregations can become compassionate partners in care by providing spiritual, emotional, and social support that complements the work of interdisciplinary palliative care teams.
The conversation also reflects on the evolution of hospice and palliative care, the enduring value of mentorship and leadership, and the fulfillment that comes from continuing to serve beyond a traditional career. Whether you're approaching retirement, considering volunteer opportunities, or looking for new ways to extend the reach of palliative care, this episode offers inspiration for finding purpose in the next season of professional life.
Judy Lentz, PhD, RN
Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP
Prolonged mechanical ventilation in rural long-term care settings brings a unique set of clinical, ethical, and logistical challenges for care teams, residents, and their families. In this episode, we explore the realities of ventilator use in rural long-term care environments, where limited resources and geographic barriers can complicate care decisions and delivery. We also take a thoughtful look at the emotional and practical impact of ventilator discontinuation, highlighting the experiences of those directly affected. Join us for a nuanced conversation that sheds light on an often-overlooked aspect of long-term care and the difficult decisions that come with it.
Von Vitto, DNP, CNP, AGNP-C, ACHPN®
Julie Thurston
Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP
In this episode of HPNA Palliative Perspective, we’re joined by Betty Ferrell—Editor of the Journal of Hospice & Palliative Nursing (JHPN), nurse, and internationally recognized researcher. As the leader of the End-of-Life Nursing Education Consortium, she brings a unique perspective shaped by decades of connection with hospice and palliative care nurses across the U.S. and around the world.
Now in her 49th year in nursing—beginning in oncology and entering hospice as it emerged in the United States—Dr. Ferrell reflects on the remarkable growth of the field and where we stand today.
At the heart of this conversation is the idea of a “professional home.” Drawing on the foundational work of pioneers like Florence Wald and Cicely Saunders, she highlights the enduring importance of interprofessional, whole-person care—and the need to stay grounded in those values as the field evolves.
In a time that can feel complex and demanding, this episode offers a clear message: you don’t have to do this work alone. Finding your people, building community, and staying connected—through colleagues and organizations like the Hospice and Palliative Nurses Association—are essential to sustaining both practice and purpose.
A thoughtful and reassuring conversation about belonging, connection, and the future of hospice and palliative nursing.
Betty Ferrell, RN, PhD, MA, CHPN®, FAAN, FPCN®
Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP
Hospice care is often structured around a 40-hour workweek—but patients and families need support 24/7. In this episode, we explore what happens during the “other 123 hours”: nights, weekends, and holidays when staffing is leaner, coverage areas expand, and each clinician carries greater responsibility—even as symptom crises and end-of-life transitions unfold. Through frontline insights, we examine the risks, resilience, and resourcefulness that define after-hours care—and discuss practical strategies to strengthen continuity, safety, and support across the full week.
Djenie Helne, DNP, FNP-BC, CRNP, ACHPN®
Dr. Helne is recognized for her expertise in clinical operations, regulatory readiness, telehealth innovation, and interdisciplinary care models. She has held leadership, hospitalist, and academic roles, including faculty appointments at Johns Hopkins University and Santa Fe College. Fluent in Haitian Kreyòl and proficient in Spanish, she is deeply committed to equitable, patient-centered care and building collaborative clinical environments that drive excellence in outcomes and operational performance.
Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP
In this episode, filmmakers Barry Koch and Jason Zamer are joined by Angela Novas, Chief Medical Officer of the Hospice Foundation of America, to discuss A Butterfly Has Been Released. The documentary follows hospice nurse Allyson during the final 39 days of her life with brain cancer. Determined to turn her dying into a teaching moment, she hosts a living funeral, shares deep conversations with loved ones, and chooses a natural green burial—modeling agency and intention through the end of life.
Barry and Jason reflect on the emotional and ethical realities of documenting such an intimate journey, while Angela offers a hospice leadership perspective on what the film reveals about patient autonomy and end-of-life care. Together, they explore how storytelling can reshape conversations about death and grief.
This episode invites palliative and hospice professionals to reflect on what happens when the caregiver becomes the patient—and how narrative can be a powerful vehicle for change.
“A Butterfly Has Been Released” is available for individual and community viewing, with and without continuing education credit at Hospice Foundation of America website.
Barry Koch
Jason Zamer
Angela Novas
Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP
In this powerful episode, longtime HPNA member Linda Blum, APRN shares experiences from the last few years of her rich nursing career in volunteerism —training incarcerated caregivers in a California state prison hospice program. Linda explores the ethical complexity of end-of-life care behind bars, from POLST conflicts and CPR decisions to pain management in a correctional setting where Medicare rules don’t apply.
Through ELNEC education and interdisciplinary collaboration, she’s helping nurses, correctional officers, and incarcerated caregivers reclaim agency and restore dignity at the end of life. This conversation examines moral distress, serious illness communication, and the transformative power of “risking love” in some of the most marginalized settings.
A moving reflection on bearing witness, professional courage, and the light within us all.
About Humane Prison Hospice Project
The Humane Prison Hospice Project is developing a humanitarian, cost-effective, and transformative solution to ensure that those aging and dying in prison receive compassionate care. Since 2017, the Humane Prison Hospice Project has worked to ensure that incarcerated individuals receive compassionate end-of-life care from trained peers. Humane implements a comprehensive 80-hour, 15-module curriculum to train incarcerated individuals as peer caregivers, equipping them with the skills to provide hands-on care and emotional support to their aging and terminally ill peers. Graduates of this program are part of a growing movement to humanize end-of-life care behind bars. Since launching this initiative, we have trained over 150 peer caregivers across California prisons, and are bringing our programming to three states—Michigan, Washington, and Oregon—marking our first step toward national replication. Learn more on their website: https://humaneprisonhospiceproject.org/
For anyone listening who has experience in hospice, nursing, programming in prisons or facilitating, and you live in CA, WA, MI, or OR, Humane is seeking volunteer facilitators who participate in trainings for peer caregivers in prisons across each state. We'd love to hear from you -- please reach out to Camila Ryder at [email protected] with your name, location, and any relevant experience. If you're interested in learning more, register via Zoom for one of our virtual monthly Informational Meetings.
Linda Blum, GNP, MSN, RN
Linda worked in home infusion and home hospice as a case manager and manager before returning to school for her at UCSF and then completing a palliative medicine fellowship at the VA in Palo Alto. She was hired as the first clinician to provide palliative care/medicine consultation at California Pacific Medical Center.
Since retiring in 2023, Linda has volunteered her time and expertise with the Humane Prison Hospice Project, where she facilitates training for incarcerated individuals serving as peer caregivers. Her passion is helping to train nurses and professional staff in the carceral setting using a modified ELNEC curriculum.
Linda enjoys traveling, caring for her grandchildren, and telling silly jokes and puns. Her spirit animal is a penguin—preferably a Gentoo—and if you ask for photos, your inbox may quickly overflow.
Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP
Health care inclusivity is more than a framework, it’s a daily practice that shapes learning, teamwork, and patient outcomes. In this episode of HPNA’s Palliative Perspective, Jill, Vanessa, and Jenn—longtime collaborators in nursing professional development and creators of Disruptor Diaries—explore what health care inclusivity truly means across education, clinical practice, and the workforce.
Drawing from lived experience in cardiovascular, neuro-trauma ICU, emergency nursing, home health, and hospice and palliative care, the guests discuss inclusive and active learning environments, the importance of belonging, and how thoughtful, aware interactions can transform both professional development and patient care. They also share the “why” behind their self-published learning guide Healthcare Education: Strategies for Inclusive Learning, created to fill a critical gap in healthcare education during a complex political and organizational landscape.
This conversation invites listeners of all roles to reflect: Am I creating an inclusive environment? What is important to this person? And why does inclusivity matter now more than ever?
Jillian Russell, MSN, RN, NPDA-BC®
Jennifer Bodine, DNP, MHA, RN, NPDA-BC®, CEN
healthcare professionals, regardless of their setting. Jenn brings a thoughtful, learner-centered approach to professional development. Driven by a passion for equity and lifelong learning, Jenn believes that when healthcare teams feel seen, supported, and valued, they are better equipped to collaborate, innovate, and deliver patient-centered care.
Vanessa Cameron, MSN, RN, NPD-BC, CEN, CNL
Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP
In this moving episode of HPNA Palliative Perspective, we welcome Esther Pepper, RN, BSN, CHPN®, a veteran hospice nurse from Alaska whose more than two decades of compassionate service have shaped her debut memoir, My Calling: Chronicles of an Alaskan Hospice Nurse.
Drawing from years on the front lines of end-of-life care, Esther shares what hospice nursing truly looks like—the challenges, the grace, and the profound human connections formed along the way. Together, we explore the emotional and spiritual dimensions of dying that often go unspoken, practical strategies for symptom management, and how caregivers can nurture both their patients and themselves.
Join us for a heartfelt conversation that celebrates the courage, compassion, and calling behind hospice work—and the enduring lessons learned from those at life’s final threshold.
Esther Pepper, RN, BSN, CHPN®
Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP
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