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End of life care decisions

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6 papers 0 to 25 followers
By Arthur Cronwright Aspiring to best practice always
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April 2015: AACN Advanced Critical Care
Sheryl L Hollyday, Denise Buonocore
The intensive care unit is a high-stakes environment in which nurses, including advanced practice registered nurses (APRNs), often assist patients and families to navigate life and death situations. These high-stakes situations often require discussions that include bad news and discussions about goals of care or limiting aggressive care, and APRNs must develop expertise and techniques to be skilled communicators for conducting these crucial conversations. This article explores the art of communication, the learned skill of delivering bad news in the health care setting, and the incorporation of this news into a discussion about goals of care for patients...
April 2015: AACN Advanced Critical Care
Debra L Wiegand, Julia MacMillan, Maiara Rogrigues dos Santos, Regina Szylit Bousso
Critical care nurses and advanced practice registered nurses frequently face bioethical dilemmas in clinical practice that are related to palliative and end-of-life care. Many of these dilemmas are associated with decisions made concerning continuing, limiting, or withdrawing life-sustaining treatments. The purpose of this article is to describe common ethical challenges through case study presentations and discuss approaches that critical care nurses and advanced practice registered nurses in collaboration with the interdisciplinary team can use to address these challenges...
April 2015: AACN Advanced Critical Care
R Førde, O G Aasland
BACKGROUND: End-of-life decisions, including limitation of life prolonging treatment, may be emotionally, ethically and legally challenging. Euthanasia and physician-assisted suicide (PAS) are illegal in Norway. A study from 2000 indicated that these practices occur infrequently in Norway. METHODS: In 2012, a postal questionnaire addressing experience with limitation of life-prolonging treatment for non-medical reasons was sent to a representative sample of 1792 members of the Norwegian Medical Association (7...
October 2014: Acta Anaesthesiologica Scandinavica
Y-Y Chen, S J Youngner
Venneman and colleagues argue that "do not resuscitate" (DNR) is problematic and should be replaced by "allow natural death" (AND). Their argument is flawed. First, while end-of-life discussions should be as positive as possible, they cannot and should not sidestep painful but necessary confrontations with morality. Second, while DNR can indeed be nonspecific and confusing, AND merely replaces one problematic term with another. Finally, the study's results are not generalisable to the populations of physicians and working nurses and certainly do not support the authors' claim that there is a movement to replace DNR with AND...
December 2008: Journal of Medical Ethics
Ruth Wittmann-Price, Linda M Celia
Many patients spend their last days in expensive, painful intensive care units instead of receiving comfortable, palliative care. This study surveyed perceptions of physicians and nurses about using the more holistic "allow natural death" (AND) terminology in end-of-life care as opposed to the current "do not resusciate" (DNR) order.
November 2010: Holistic Nursing Practice
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