Providing end-of-life care in the highly technical critical care environment can be challenging. Despite advances in medicine and our best efforts, it is estimated that 10% to 29% of adults will die in the intensive care unit (ICU). Often, deaths in the ICU occur when the decision is made to withdraw treatment and make the patient comfortable. Once that decision is made, nurses must quickly change their focus from life-sustaining and curative treatments to end-of-life care, while still surrounded by the complexity of the environment. This transition can be stressful for nurses and upsetting to patients and their families. Much of the distress is a result of the overall atmosphere: fast-paced, noisy, and chaotic at times, hardly comforting at a time when comfort is the goal. The nurses in our 14-bed adult medical-surgical ICU wanted to find a way to...

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