Leadership DIMENSIONIntensive Care Unit Nurse: Could We Call a Palliative Care Consult? Intensive Care Unit Provider: It's Too Early. Palliative Care Integration in the Intensive Care Unit: The Struggle to Translate Evidence Into PracticeMcAndrew, Natalie S. PhD, RN, ACNS-BC, CCRN-K; Guttormson, Jill PhD, RN; Marks, Sean MD; Rhodes, Mary MD; Patel, Jayshil MD; McCracken, Colleen BSN, RN, CMSRN, CHPN, OCNAuthor Information Natalie S. McAndrew, PhD, RN, ACNS-BC, CCRN-K, is an assistant professor at the College of Nursing, University of Wisconsin-Milwaukee. She is also a nurse scientist at Froedtert & the Medical College of Wisconsin Froedtert Hospital, Milwaukee. Her research interests include palliative integration in the ICU setting and the development of palliative-based interventions to support patients and families in acute and critical care. Jill Guttormson, PhD, RN, is an associate professor at the College of Nursing, Marquette University, Milwaukee. Her research interests include improving communication with mechanically ventilated patients and patient symptom management in the ICU setting. Sean Marks, MD, is an associate professor at the Division of Hematology & Oncology, Palliative Care Section, at Medical College of Wisconsin, Milwaukee. His research interests include improving prognostic discussions and standardization in palliative care practice. Mary Rhodes, MD, is an assistant professor at the Division of Hematology & Oncology, Palliative Care Section, at Medical College of Wisconsin, Milwaukee. Her research interests include palliative communication and the influence of language and culture on serious illness conversations. Jayshil Patel, MD, is an associate professor at the Division of Pulmonary and Critical Care Medicine at Medical College of Wisconsin, Milwaukee. His research interests include risk stratification and outcomes in critical care patients and their families, as well as optimizing end of life care, including communication and nutrition support. Colleen McCracken, BSN, RN, CMSRN, CHPN, OCN, is a nurse educator for the Inpatient Oncology Unit at Froedtert & the Medical College of Wisconsin Froedtert Hospital, Milwaukee. Her research interests include advance care planning and the integration of palliative care in oncology populations. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Address correspondence and reprint requests to: Natalie S. McAndrew, PhD, RN, ACNS-BC, CCRN-K, College of Nursing, University of Wisconsin-Milwaukee, 1921 East Hartford Avenue, Milwaukee, WI 53211 ([email protected]). Dimensions of Critical Care Nursing: 1/2 2021 - Volume 40 - Issue 1 - p 51-58 doi: 10.1097/DCC.0000000000000451 Buy Metrics Abstract Despite evidence regarding the value of palliative care, there remains a translation-to-practice gap in the intensive care setting. The purpose of this article is to describe challenges and propose solutions to palliative care integration through the presentation and discussion of a critical care patient scenario. We also present recommendations for a collaborative palliative care practice framework that holds the potential to improve quality of life for patients and families. Collaborative palliative care is characterized by close working relationships with families, interprofessional intensive care unit healthcare teams, and palliative care specialists. The shortage of palliative care specialists has become a pressing policy and practice issue and highlights the importance of increasing primary palliative care delivery by the intensive care team. Underexplored aspects of collaborative palliative care delivery include the interprofessional communication required, identification of key skills, and expected outcomes. Increased recognition of intensive care unit palliative care as a process of engagement among nurses, providers, patients, and their family members heralds a vital culture shift toward collaborative palliative care. The interprofessional palliative specialist team has the expertise to support intensive care teams in developing their primary palliative skills and recognizing when specialist palliative care support is required. Promotion of strategic palliative care delivery through this collaborative framework has the potential to decrease suffering among patients and families and reduce moral distress among healthcare professionals. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.