Heidi Mason
University of Michigan, USA
Title: Ethical considerations in end of life discussions: How nurses can make a difference
Biography
Biography: Heidi Mason
Abstract
Patients have a right to compassionate and respectful care during the final stages of their lives. End of life discussions need to focus on promoting the optimal well-being of patients. To accomplish this, providers need open and honest dialogue with patients and their loved ones. It should begin early, as the patient transitions into a more palliative care stage, and be continuous, re-addressed as changes in the their status occur. End of life care requires a multidisciplinary team, if nurses are left out of the process, the opportunity to provide the best possible care during this final stage in life will be missed. Nurses are in a unique position to initiate end of life discussions. The nurse-patient relationship lends to a more open and easy communication pattern. Nurses are often aware of the values and goals of patients since they are involved in their day-to-day care. This intimacy helps nurses recognize beginning signs of transition into a more palliative care mode allowing them to initiate difficult conversations earlier. Nurses promote health throughout the continuum of life, including the dying process. The ANA nursing code of ethics mandate nurses to take an active role in end of life care. It specifically states that nurses should assist patients in decisions regarding resuscitation, aggressive care, nutrition and other heroic measures. A survey of nurses at University of Michigan Cancer Center demonstrates a lack of comfort and knowledge regarding their ethical responsibility in end of life care. Further education, especially inter-professional education, is warranted.