1. Reynolds, Mary Anne Hales PhD, RACNS-BC

Article Content


The purpose of this presentation was to identify and discuss the unique needs and issues of young and middle-aged adults receiving end-of-life care.



End-of-life care is most often associated with the elderly. Yet, last year, almost 500,000 adults between the ages of 20 and 59 years died from acute and chronic related injuries and illnesses. Injuries were associated with accidents, suicide, and assault. Illnesses included heart disease, cancer, cerebrovascular diseases, and other chronic disorders often associated with an older population.



With few exceptions, these young and middle-aged adults and their families have come into contact with multiple healthcare providers in multiple settings, often at critical diagnostic, treatment, and decision-making points.



Based on the life span developmental model, the young and middle-aged adult has unique developmental experiences that have been influenced by historical events. As a consequence, age and life experiences impact their end-of-life care related to treatments and the critical decisions related to that care.



Depending on the diagnosis, the young or middle-aged terminally ill adult may be cared for in many settings including acute care emergency rooms, intensive care units and medical and surgical floors, long-term care and hospice facilities, and home care. In addition, many patients are followed in general and specialty practices such as oncology or cardiac.



Clinical nurse specialists are in many of these settings, and they have the opportunity to provide important specialized information, to coordinate and provide complex end-of-life care, and to facilitate important decisions that must be made by the patient and/or family members.


Implications for Practice:

By being knowledgeable about young and middle-aged adults and end-of -ife care issues, the clinical nurse specialist will be able to provide the very best of care to patients and their families during a very critical life experience.


Section Description

The 2009 NACNS National Conference will be held in St Louis, Missouri, on March 5 to 7. More than 350 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are registered. This year's theme, "Clinical Nurse Specialists: Vision, Value, Voice," demonstrates the essential leadership skills of the CNS as well as the CNS role in implementing evidence-based practice.


Seventy abstracts were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session. The abstracts addressed CNS practice in 3 practice domains (spheres of influence), emphasizing patient safety and quality care outcomes, leadership, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into 3 spheres of influence-patients, nursing practice, organization/system-including the development of clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, CNS practice in end-of-life care decisions, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNSs' contribution to the well-being of individuals, families, communities, as well as to the advancement of the nursing profession.


The conference abstracts were published here to facilitate sharing this emerging new knowledge with those who were unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We encourage you to contact individual presenters to network, collaborate, consult, or share your thoughts and ideas on the conference topics. Watch out for next year's call for abstracts and consider submitting for presentation at NACNS' next annual conference in Portland, Oregon, on March 4 to 6, 2010.