The majority of deaths occur in the hospital setting, and of these deaths, 20% are in an intensive care unit (ICU). Care provided on the ICU shifts from curative to palliative when a patient's death appears to be imminent. Nursing care decisions made at the end of life are critical to the experience of the patient, and leave a lasting impression on the patient's family and the nurses involved in providing care. One of the main concerns of family members during this time is the comfort of their loved one. Assessing comfort can be especially difficult in the patient who is unresponsive. One tool that can assist the nurse in the assessment and management of analgesic effectiveness is the Bispectral (BIS) Index Monitor. As the use of BIS monitoring grows in the ICU setting, more information will be available that will help all involved in the palliative care process ensure patients have a peaceful death.
Questions or comments about this article may be directed to Meg Gambrell, BSN RN, at 2206 Parkside Dr., Durham, NC 27707, or by e-mail to firstname.lastname@example.org. She is a predoctoral fellow at the University of North Carolina at Chapel Hill School of Nursing.
© 2005 American Association of Neuroscience Nurses