Because of the severity of illness of the patients, the intensive care unit (ICU)
is a setting where death is common. Of patients who die in the hospital, approximately
half are cared for in an ICU within 3 days of their death and one third spent at least
10 days in the ICU during their final hospitalization [
[1]
]. Many studies have shown that the majority of deaths in the ICU involve withholding
or withdrawing multiple life-sustaining therapies [
2
,
3
,
4
,
5
,
6
,
7
,
8
,
9
,
10
,
11
]. Thus, the ICU represents a setting where decisions about managing the dying and
death of patients are made on a frequent basis. These decisions involve communication
among the critical care clinicians caring for the patient and the patient and his
or her family and loved ones. Talking about end-of-life care can be difficult for
clinicians in many settings, but may be especially difficult in the ICU because the
culture and mission of the ICU is oriented to saving lives [
12
,
13
]. Nonetheless, because a relatively large proportion of patients in the ICU die, providing
high-quality end-of-life care to patients and their families is an important part
of critical care. Therefore, all ICU clinicians need to learn effective communication
skills to provide high-quality care to patients and their families.To read this article in full you will need to make a payment
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Article info
Footnotes
☆Funded by an RO1 Grant from the National Institute of Nursing Research (2 RO1NR005226).
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
