End-of-life care in the intensive care unit: a challenge for nurses.
Results from several research studies combined with increasing public tensions surrounding physician-assisted suicide have fueled a growing awareness of the inadequacies of end-of-life care. Investigators also suggest that intensive care unit nurses have a limited role in end-of-life decision making and care planning. This article explores cultural issues influencing end-of-life care in intensive care units, explores factors surrounding the limited involvement of critical care nurses in end-of-life decision making and care planning, and offers recommendations for changing nursing practice. Because improving end-of-life care will require cultural changes, an understanding of the cultural issues involved is needed. Recommendations for changing nursing practice include a model of end-of-life care that incorporates the goals of both cure and comfort care, as well as a shared decision-making process. Nurses are essential to improving end-of-life care in today's intensive care units.
Miller
P A
PA
University of Kansas School of Nursing, Kansas City, Kan., USA.
Forbes
S
S
Boyle
D K
DK
D000368:Aged; D002985:Clinical Protocols; D016638:Critical Illness / Q000451:nursing; D003657:Decision Making; D004509:Education, Nursing, Continuing; D006040:Goals; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration / Q000592:standards*; D016294:Models, Nursing; D024802:Nurse's Role; D009741:Nursing Staff, Hospital; D015279:Organizational Culture; D010166:Palliative Care; D013727:Terminal Care / Q000458:organization & administration / Q000592:standards*; D014481:United States