Abstract
Establishing cross-cultural educational exchanges is an effective way of improving end-of-life care with patients in all parts of the world. This article describes the process of developing an initiative between two colleges of nursing in the United States and hospices in Romania. Site visits by nursing faculty from these two colleges to Romania served to be the most effective approach in forging this educational initiative. Once collegial and trusting relationships were established, teleconferencing was used as the educational approach among these three sites. Challenges in understanding cultural differences and the impact of economic constraints on pain and symptom control are examined through the discussion of a specific case. The benefits for the nurses in the hospices in Romania and nursing faculty and students in the United States are presented.