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advance directives, critical care nurses, end-of-life care, facilitating behaviors, palliative care



  1. Gross, Ariana G. RN, MSN, CCRN, SANE/A


Critical care units are places where aggressive treatment modalities, combined with advanced technological support, are used to care for patients with a goal for cure or restoration. However, the intensive care unit is a common location where patient deaths occur because of the high complexity of these patients' medical conditions. Nurses must often change the focus of their care from a curative to an end-of-life care mode. Improvement of end-of-life care requires the establishment of evidence-based practices. The purpose of this project was to investigate critical care nurses' perceptions of obstacles to and facilitators of end-of-life care. Results of this study demonstrate that nurses perceive physicians' overly optimistic behavior regarding their patients' prognosis, families not understanding the meaning of life support measures, and continuing aggressive treatments on patients who have advance directives, as obstacles. The nurses identified physician agreement on the direction of care and families' acceptance of poor prognosis as facilitators.