Pediatric critical care nurses face numerous end-of-life issues on a daily basis. In addition to meeting the needs of critically ill children, nurses must also be prepared to meet the needs of the children’s family members within the framework of providing family-centered care (Table 1). A patient’s family may include parents or guardians, siblings, and extended family, all of whom have very diverse needs. Ideally, when a death is expected, do-not-resuscitate orders are in place and a planned withdrawal of support can occur, facilitating a more “peaceful” or “good” death for that patient and the patient’s family. Other times, death can be unexpected, occurring after a sudden accident or an unanticipated resuscitation. Multiple issues often arise, including, but not limited to, planning and implementing palliative care, explaining brain death, and offering the option of organ donation to patients’...

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