Role of Advanced Practice in End-of-life Discussions essay

Roleof Advanced Practice in End-of-life Discussions

Roleof Advanced Practice in End-of-life Discussions

Researchhas shown the need for patients and families to be given ongoingmedical prognostic information however, the physicians find itdifficult to make such conversations before the patients make it tothe advanced stages of the disease trajectory (Lianchenko et al.,2009). The delay is even significant in cases where the prognosis isunfavorable thereby denying patients and families the opportunity tomake critical decisions. Before the end of life conversationsphysicians normally consider hospice care discussions, which is akind of conversation that enables patients to make a decision abouttheir care and the rest of their life. This conversation should bedone at the convenience of the patient allowing them to decide toparticipate or reject it. In the course of such a rejection, themedical practitioner should then respond to the demands of thepatient and his family (Hov et al., 2007).

Advancedpractice registered nurses, therefore, have a critical role to playin the formulating and implementation of holistic strategies tobetter the prognosis as well as end of life conversations withpatients together with families (Silen et al., 2008). It is importantfor physicians to keep discussing the deterioration conditions of thepatient with his or her family. Any characteristic that indicates adecline in the functional status of the patient must be revealed inreal time to enable crucial decision making. Other than thisinformation, broker role and information giving to the family, otherstrategies could include mediation, being empathetic, offeringsupport, build trust between the family and physicians and advocacyroles (Judith et al., 2011).

Inthe case of Mrs. Sloan given her end of life decision, one of thepossible outcomes could be a cardiac failure as she has preempted andgiven that it is her wish not to undergo resuscitation. She couldactually pass since she requested a no code status. It is, therefore,important that both the family and the medics are involved in thisconversation.


Hov,R., Hedelin, S., &amp Athlin, E. (2007). “Being an intensive carenurse related to questions of withholding or withdrawing curativetreatment.” Journalof Critical Nursing,16,203-207.

Judith,A. A., Donald, E., Ruth, A. &amp Sharon, L. (2011). Nursing rolesand strategies in end-of-life decision making in acute care: Asystematic review of the literature. NursingResearch and Practice,45-60.

Liaschenko,J., O’Conner-Von, S. &amp Peden, M. (2009). The “The bigpicture”: Communicating with families about end-of-life care inintensive care unit. Dimensionsof Critical Care Nursing,28,224-227.

Silen,M., Svatesson, M. &amp Alhlstrom, G. (2008). “Nurses Conceptionsof decision making concerning life-sustaining treatment,” NursingEthics,15,160-161.