An exploration of collaboration in end-of-life decision making among intensive care physicians and nurses
Date
2012-08-08
Authors
Driver, Lorelei
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Abstract
“A dying man needs to die, as a sleepy man needs to sleep, and there
comes a time when it is wrong, as well as useless, to resist.”---Stewart Alsop
The life-saving focus of intensive care, coupled with patients who are too ill to participate
in their own end-of-life decisions, creates challenges to ensure healthcare professionals respect
and follow patients’ health care wishes. Combining an understanding of patient choices with
clinical expertise and compassion is the quintessential goal. Good collaborative communication
with families, and within the healthcare team, is the single most important factor for achieving
quality end-of-life care for patients and reducing negative outcomes (Boyle & Kochinda, 2004;
Curtis, et al., 2001; Levy, 2001; Puntillo & McAdam, 2006).
Maximizing nurse physician collaboration holds promise to improve not only patient and
family member care, but also has been shown to improve intensive care unit (ICU) nurses and
physicians’ workplace satisfaction. Overcoming the barriers for effective communication and
collaboration remains the challenge. My purpose, in this paper, is to critically examine and
present an in-depth analysis of the multiple factors that both impede, and facilitate, collaborative
end-of-life decision-making among intensive care nurses and physicians. Following this analysis,
I propose several recommendations to facilitate collaboration among nurses and physicians.
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Keywords
exploration, collaboration, end-of-life, decision making, intensive care, nurses, physicians