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Western Journal of Nursing Research
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Nursing Roles in End-of-Life Decision Making in Critical Care Settings

Vicky Bach

Fraser Health Authority, jvbach{at}shaw.ca

Jenny Ploeg

McMaster University

Margaret Black

McMaster University

This study used a grounded theory approach to formulate a conceptual framework of the nursing role in end-of-life decision making in a critical care setting. Fourteen nurses from an intensive care unit and cardio-respiratory care unit were interviewed. The core concept, Supporting the Journey, became evident in four major themes: Being There, A Voice to Speak Up, Enable Coming to Terms, and Helping to Let Go. Nurses described being present with patients and families to validate feelings and give emotional support. Nursing work, while bridging the journey between life and death, imparted strength and resilience and helped overcome barriers to ensure that patients received holistic care. The conceptual framework challenges nurses to be present with patients and families at the end of life, clarify and interpret information, and help families come to terms with end-of-life decisions and release their loved ones.

Key Words: end of life • decision making • grounded theory • nursing • ICU • critical care

This version was published on June 1, 2009

Western Journal of Nursing Research, Vol. 31, No. 4, 496-512 (2009)
DOI: 10.1177/0193945908331178
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