title: Hoping for the best, preparing for the worst: strategies to promote honesty and prevent medical futility at end-of-life.
abstract: Critical care nurses frequently care for patients nearing end of life. Associated advance care planning is often not introduced as early as it needs to be, and nurses can help to stimulate a culture change by initiating honest discussions about end-of-life treatment options. The Physician Orders for Life-Sustaining Treatment form can provide a framework for honesty and information sharing at end of life. This article discusses the use of the Physician Orders for Life-Sustaining Treatment form as an end-of-life care planning tool as well as evidence-based communication strategies that promote honest, effective end-of-life conversations.
authors: Arisa F. Nogler, MSN, BA, RN, works as a staff nurse on the Coronary Care Unit at Tacoma General Hospital, Tacoma, Washington. Research interests include mental health, end-of-life care, nutrition, and complementary and alternative therapies.
authors: Arisa F
authors: AF
authors: Nogler
mesh_terms: D032722:Advance Care Planning; D006801:Humans; D018447:Medical Futility; D024802:Nurse's Role; D015279:Organizational Culture; D010344:Patient Advocacy; D011368:Professional-Family Relations; D013727:Terminal Care