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College of Nursing

A Better End

New faculty member adds expertise in pediatric pain management and palliative care
by Laura Kammerer,

It was a typical evening on the medical unit floor for Cheryl Mele, who dashed from room to room administering meds and tending to 30 patients.

That changed when an 18-year-old cancer patient pleaded with her to stay. Mele, then a registered nurse, couldn’t halt mid-shift but returned to his room afterward.

The teenaged boy was upset. He had questions. He needed to talk. He was afraid of dying and in pain. He wanted to go home.

That conversation in the 1980s changed the career trajectory of Mele, an expert in pediatric palliative care and pain management who joined the College of Nursing as a clinical associate professor in January.

“I felt there needs to be a better way to provide care for patients and families who don’t have a curative disease but still want a better quality of life. My passion grew before palliative care evolved as a specialty practice. I realized nurses were in key in promoting effective change in patients and families with chronic conditions and end of life care.”

- Dr. Cheryl Mele, Clincal Associate Professor

Mele, a D.N.P., came to Carolina after serving in nursing colleges in the greater Philadelphia area and maintaining clinical appointments, most recently at the renowned Children’s Hospital of Philadelphia.

As an advanced practice nurse in pediatric acute care and neonatology units, she served on hospital bereavement committees, worked on interdisciplinary palliative care initiatives and developed a workshop for advance practice providers about communicating bad news to patients and families. Mele has also published articles and presented nationally on pediatric pain management and communication with patients and families and developed curricula for acute care pediatric nurse practitioner and dual pediatric nurse practitioner graduate programs.

At Carolina, she hopes to create a pediatric nurse practitioner program as well as participate in developing a palliative care certificate program.

Because of her pediatric practice experience, Mele said she wants to reach out to the college’s clinical partners to explore models of care using pediatric nurse practitioners as first-line providers of patient care in inpatient and outpatient settings. PNPs have unique training and, if utilized as direct providers, can improve patient satisfaction and outcomes, Mele said.

She also wants to play a role in expanding the use of pediatric palliative care best practices across the state. For instance, Mele said she would like to educate partners about when to initiate palliative care, noting that patients and families can benefit from services long before death is imminent.

Moreover, Mele plans to implement the training workshop she developed at CHOP to train advanced practice nursing students about how to initiate difficult conversations and share diagnoses with patients and families, especially in palliative care.

Pediatric palliative care is a challenging field because caregivers are often caring for patients as well as their families, who are grappling with grief and guilt about their child’s condition and may need referrals for respite care, she said, and pain medications may have side effects such as grogginess or confusion that hamper a patient’s quality of life.

Mele said she came to the College of Nursing because of its unique environment where clinical and research faculty regularly work together to advance patient care.

“I believe the blend of an expert researcher and clinician work well together, and I haven’t encountered that type of collaborative energy with other universities.”


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