• Nikolaos Efstathiou and Collette Clifford.
• University of Birmingham, College of Medical and Dental Sciences, School of Health and Population Sciences, Nursing and Physiotherapy, Birmingham, UK. n.efstathiou@bham.ac.uk
• Nurs Crit Care. 2011 May 1; 16 (3): 116-23.

AimThe purpose of this article is to discuss the challenges critical care nurses face when looking after patients needing End-of-Life (EoL) care in critical care environments.BackgroundCritical care nurses frequently provide care to patients who fail to respond to treatments offered to support and prolong life. The dying phase for individuals in critical care settings, commonly after withholding/withdrawing treatment, is very short posing great demands on critical care nurses to provide physical and emotional support to both patients and their families. Despite the existence of recognized care planning frameworks that may help nurses in providing EoL care, these are not used by all units and many nurses rely on experience to inform practice. A number of aspects such as communication, patient/family-centred decision-making, continuity of care, emotional/spiritual support and support for health professionals have been indicated as contributing factors towards the provision of effective EoL care. These are considered from the perspective of critical care nursing.ConclusionSkills development in key aspects of care provision may improve the provision of EoL care for critical care patients and their families.Relevance To Clinical PracticeCritical care nurses have an essential role in the provision of effective EoL care; however, this dimension of their role needs further exploration. It is noted that educational opportunities need to be provided for critical care nurses to increase the knowledge on planning and delivering EoL care. To inform this evaluation of current EoL care provision in critical care is necessary to address a knowledge deficit of the needs of nurses who seek to support patients and their families at a critical time.© 2011 The Authors. Nursing in Critical Care © 2011 British Association of Critical Care Nurses.

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