Canadian hospital nurses' roles in communication and decision-making about goals of care: An interpretive description of critical incidents

Review article: Goals‐of‐care discussions for adult patients nearing end of life in emergency departments: A systematic review

“…32 Regarding the consultation itself, there is potential for other team members such as nursing staff to identify patients in need of discussions or to facilitate the discussions. 33 The discussions should not need to be significantly modified for cultural contexts as they should already be patient-centred. 34 Nonetheless, racial and cultural biases might be subconscious and could lead to misunderstandings about patient values, goals and preferences, 35 and all clinicians should be aware of the potential for bias.…”

Improving End-of-Life Care for Hospitalized Older Adults: What Can Nurses and Health Care Systems Do?

“…Traditionally, formal goals of care conversations in hospitals have been conducted by the primary inpatient provider in the form of patient consultations and family conferences. In addition to these provider-mediated conversations, bedside nurses play a critical role in communication about goals of care (Strachan, Kryworuchko, Nouvet, Downar, & You, 2018). Because nurses work closely with patients and their families, they are in a unique position to build relationships and engage these individuals in conversations about their concerns regarding their illness and what they value most moving forward.…”

“…Because nurses work closely with patients and their families, they are in a unique position to build relationships and engage these individuals in conversations about their concerns regarding their illness and what they value most moving forward. Unfortunately, for many reasons, including lack of education and training, discomfort with goals of care conversations, varying practice barriers, and hierarchy among team members, there is a wide variance in nurse participation in this role (Coyle et al, 2015;Strachan et al, 2018).…”

“…To better serve patients with serious illness, not only can nurses work to increase their involvement in goals of care discussions, but health systems can also help support and empower nurses to participate in these conversations. Providing formal and informal opportunities to include nurses in goals of care conversations have been shown to help improve the quality of care provided to hospitalized patients at end of life (Burm et al, 2019;Reyniers et al, 2014;Strachan et al, 2018;Wittenberg, Ferrell, Goldsmith, Buller, & Neiman, 2016). Nurses are in a position to gain an understanding of patients' baseline versus current health status, to incorporate a more holistic perspective of the patient, and to discuss their wishes for end of life (Burm et al, 2019).…”

Evidenced‐based practice of decision‐making process in oncofertility care among registered nurses: A qualitative study

“…When nurses are in a cure‐directed treatment culture, they may be unable to persist the caring values (Jerpseth et al., 2017). Nursing roles could be determined by unit routines, physician practices and preferences and their self‐confidence in supporting decision‐making (Strachan et al., 2018). When nurses’ decisions involving some level of uncertainty that require moral reasoning or values‐based judgement, empathy and ethics are connected and both play a vital role in the decision‐making process (Adams, 2018; Barlow et al., 2018).…”