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Strategies to Improve End-of-life Care in the Intensive Care Unit

Ciccarello, Gail P. RN, MS

Leadership DIMENSION

Death is a frequent occurrence in the intensive care unit (ICU). Critical care nurses often feel unprepared to deliver expert end-of-life care. This article proposes specific strategies for critical care nurses to improve the delivery of end-of-life care in the ICU. Critical care nurses can examine beliefs about death; recognize that cure and palliative care coexist; create an environment that supports dying as well as curing; improve communication among providers, patients, and families; provide “small things that make a big difference” at the end-of-life; and locate and utilize support for improving end-of-life care.


Gail P. Ciccarello, RN, MS, is a graduate of the Acute Care Nurse Practitioner/Clinical Nurse Specialist program in Trauma/Critical Care/Emergency Nursing at the University of Maryland at Baltimore School of Nursing. She is currently a clinical instructor in the Department of Adult Health Nursing at the University of Maryland School of Nursing and a Nurse with Hospices of the National Campaign Region. She has worked as a critical care staff nurse.

Address correspondence to: Gail P. Ciccarello, 1808 Old Meadow Rd, Apt 112, McLean, VA 22102 (e-mail:

© 2003 Lippincott Williams & Wilkins, Inc.