ESSAY: End of Life

3 pages that discusses the laws, policies, and choices surrounding end-of-life health care decisions.

See Assessment 3 Brainstorming document for additional information.


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End of Life


            Making End of life decisions is often a difficult practice and encompasses making challenging choices on whether to start or discontinue a life support initiative to patient who are in critical condition such as having cardiopulmonary resuscitation to patient with cardiac arrest. EOL has been an issue of concern for years because it involves diverse areas affecting the nurses, patients, and the family (Giovanni, 2012). Patients’ ability to make informed decisions regarding their diagnosis, prognosis, treatment, and follow-ups is usually impaired when they are in critical health condition. Therefore, entrusting the responsibility to a third party becomes important. Major concerns relate to professional negligence, ethics, and legal issues. These issue arise as a result of healthcare disparities, inadequacy in EOL education, quality of care, and inadequate healthcare financing (Giovanni, 2012).

Role of The Nurse in EOL

            Nurses play vital roles including providing professional advice, educating patients, and facilitating collaboration among the patients, family members, the physicians. Roles of the nurse are categorized into information roles, supporting roles and advocacy roles (Norlander, 2014). Information role involves providing relevant information and guidance to both the patient and the family members that leads to making sound decisions. They also support interprofessional collaboration by communicating the clinical status of the patient, psychological and emotional status of the family members and the family view regarding the proposed treatment process.

            Nurses also relay medical information to the family members in a clear and understandable language. This information relates to condition of the patient, diagnosis results and equipment required. Therefore, nurses act as mediators. The support role helps nurses to establish a trusting relationship with family members, patients and physicians. The nurses strive to build trust and empathy through listening, providing feedback and understanding family views (Adams, Bailey, Anderson & Docherty, 2011). Advocacy is another key role of the nurses.

Strategies for an Effective Process

Strong communication and listening skills, patient-centered care, and the ability to deal with difficult patient behaviors are the heart of effective communication and EOL decision-making process. Therefore, advocacy and supporting efforts must be both flexible and logical in order to help nurses make informed EOL decisions that are legal and ethical (Hebert, Moore & Rooney, 2011). To achieve the desired results, the nurses engage and inform all stakeholders regarding the goals and objectives of their diagnosis and treatment decisions in order to avoid conflict of interests and resistance to change. In addition, nurses use verbal, nonverbal, and visual communication strategies to enhance understandability of their lab reports. Nurses are also open-minded, show empathy, compassion, friendliness, and express genuine interest in the patient.

Legislation That Generated EOL Policies

Legislation relating to the end-of-life decision was passed in 1944 from amendments to the Public Health Service Act, which is well-defined in Title 42 of the United States Health Code. Other critical policies are also derived from amendments to Public Health Service Act, for instance, the HIPAA act. Affordable Care Act (ACA) of 2010 in another important legislation that points out that the healthcare providers should offer compassionate and competent care to the patients without discrimination, harassment, or intimidation. The act also recommends that the nurses should be ethical and professional in the course of decision-making and need to avail the necessary planning documents to guarantee satisfactory resolution. Death with Dignity Act is also the foundation of End-of–life policies. The act determines that terminally ill patients have their rights protected in the constitution. In addition, the patients are guaranteed liberty and equal protection to make end- of life decisions more…

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