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Critical Care Nurses' Perceptions of Obstacles, Supports, and Knowledge Needed in Providing Quality End-of-Life Care

Crump, Saundra K. PhD(c), MSN, RN, CHPN; Schaffer, Marjorie A. PhD, RN; Schulte, Evie BSN, RN, LAc

doi: 10.1097/DCC.0b013e3181f0c43c
Research DIMENSION

In response to critical care nurses' perceptions of increasing stress and conflict in difficult end-of-life (EOL) situations, the researchers conducted a study to identify perceived obstacles, supports, and knowledge needed to provide quality EOL care. The conclusions were as follows: (1) families and patients need clear, direct, and consistent information to make EOL decisions; (2) physician-related issues affect nurses' ability to provide quality EOL care; (3) critical care nurses need more knowledge, skill, and a sense of cultural competency to provide quality care; and (4) having properly completed advance directives can reduce confusion about the goals of care. Recommendations for improving EOL care were made as a result of the study.

The findings of a study to identify perceived obstacles, supports, and knowledge needed to provide quality end-of-life care by critical care nurses are presented.

Saundra K. Crump, PhD(c), MSN, RN, CHPN, is a doctoral candidate and a John Hartford Geriatric Nursing Education Scholar at the University of Minnesota Center for Geriatric Nursing Excellence. At the time of this research, she was a staff nurse in the Cardiac Care Unit at Hennepin County Medical Center. She is the owner of Bioethical Solutions, Inc, a bioethics consulting company that provides education and support to professional staff and lay communities in writing advance directives and planning care in end-stage-disease.

Marjorie A. Schaffer, PhD, RN, is a professor of nursing at Bethel University, St Paul, Minnesota. She is a coauthor of "Being Present: A Nurse's Resource for End-of-Life Communication." Dr Schaffer received an award for dissemination of the End-of-Life Nursing Education Consortium curriculum. She teaches courses on end-of-life nursing care and has conducted research on ethical problems encountered by Norwegian elders in end-of-life decision making and on end-of-life discussion in assisted living facilities.

Evie Schulte, BSN, RN, LAc, is a staff nurse in the Cardiac Care Unit at Hennepin County Medical Center in Minneapolis, Minnesota.

She is also a licensed acupuncturist in the Alternative Care Center at Hennepin Faculty Associates.

All authors are certified trainers of the End-of-Life Nursing Education Consortium curriculum (ELNEC).

This work was funded by the Minnesota Nurses Association Foundation. Additional administrative support was given by Hennepin County Medical Center.

Address correspondence and reprint requests to: Saundra K. Crump, PhD(c), MSN, RN, CHPN, 1210 11th Ave N, Minneapolis, MN 55411-4407 (skcrump@earthlink.net).

© 2010 Lippincott Williams & Wilkins, Inc.