Critical care nursing clinics of North America
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Advances in medical technology during the past 3 decades altered the scenarios of our dying. It is now possible to prolong life, with the frightening reality that we also can extend death. ⋯ These issues include patients' decision-making capacity and right to refuse treatment; withholding and withdrawing life-sustaining treatment, including nutrition and hydration; "no code" decisions; medical futility; and assisted suicide. Implications for critical care practice, education, research and public policy are identified.
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Crit Care Nurs Clin North Am · Jun 2002
The integration of palliative care and critical care: one vision, one voice.
As technological advances transform health care and the American population ages, care at the end of life (EOL) assumes ever-greater significance. Nurses in all practice settings and specialties are challenged to integrate quality palliative care into patient care. Today, this imperative is unifying the nursing profession, with help of the Nursing Leadership Academy for End-of-Life Care.
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Crit Care Nurs Clin North Am · Jun 2002
Case ReportsPediatric palliative care: a family-centered model for critical care.
Melanie's case and the associated concerns are not unique. Children with life-threatening conditions and their families and communities may benefit from a family-centered model of pediatric palliative care. ⋯ An interdisciplinary and collaborative model of pediatric palliative care involves the work of many, including nurses, physicians, social workers, chaplains, child life specialists, pharmacists, ethicists, bereavement counselors, ancillary staff, volunteers, and families themselves. They must incorporate key elements of the model, including clinical services, education and training, support services, and research that address physical, mental, and spiritual needs of families, children, and communities faced with life-threatening conditions.
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Crit Care Nurs Clin North Am · Jun 2002
Case ReportsEnd of life care in the ICU: current practice and future hopes.
Dying well in the United States is not the standard of care, particularly in critical care units. A number of factors contribute to this clinical deficiency, yet opportunities and strategies to correct the deficiencies are evident through the work of end-of-life advocates and clinical pioneers in nursing and medicine. The purpose of this paper is to describe barriers to optimal end of life care in the ICU and to recommend strategies for making improvements. Ideally, all persons who are not expected to survive a critical illness will experience compassionate, comprehensive, patient and family-focused attention directed at allowing the patient to die well.
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Crit Care Nurs Clin North Am · Jun 2002
Exploring family needs during withdrawal of life support in critically ill patients.
Withdrawal of life support is a process where medical interventions are taken away from the patient with the expectation that the patient will die. This deliberate decision occurs when it is determined that medical options are exhausted and the prognosis is terminal. ⋯ Specifically, whether or not the situation was anticipated, a description of the events surrounding withdrawal, events that made the process easier, and what they would like to see changed. This information was used to determine if and to what extent family needs are met and to determine if further interventions are required.