Perspectives of physicians and nurses regarding end-of-life care in the intensive care unit

Emir Festic, Michael Wilson, Ognjen Gajic, Gavin D. Divertie, Jeffrey T. Rabatin

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Context: The delivery of end-of-life care (EOLC) in the intensive care unit (ICU) varies widely among medical care providers. The differing opinions of nurses and physicians regarding EOLC may help identify areas of improvement. Objective: To explore the differences of physicians and nurses on EOLC in the ICU and how these differences vary according to self-reported proficiency level and primary work unit. Design: Cross-sectional survey of 69 ICU physicians and 629 ICU nurses. Setting: Single tertiary care academic medical institution. Results: A total of 50 physicians (72%) and 331 nurses (53%) participated in the survey. Significant differences between physicians and nurses were noted in the following areas: ability to safely raise concerns, do not resuscitate (DNR) decision making, discussion of health care directives, timely hospice referral, spiritual assessment documentation, utilization of social services, and the availability of EOLC education. In every domain of EOLC, physicians reported a more positive perception than nurses. Additional differences were noted among physicians based on experience, as well as among nurses based on their primary work unit and self-reported proficiency level. Conclusions: Even with an increased focus on improving EOLC, significant differences continue to exist between the perspectives of nurses and physicians, as well as physicians among themselves and nurses among themselves. These differences may represent significant barriers toward providing comprehensive, consistent, and coordinated EOLC in the ICU.

Original languageEnglish (US)
Pages (from-to)45-54
Number of pages10
JournalJournal of Intensive Care Medicine
Volume27
Issue number1
DOIs
StatePublished - Feb 2012

Fingerprint

Terminal Care
Intensive Care Units
Nurses
Physicians
Hospices
Aptitude
Tertiary Healthcare
Social Work
Documentation
Decision Making
Referral and Consultation
Cross-Sectional Studies
Delivery of Health Care
Education

Keywords

  • attitude of health personnel
  • end of life
  • intensive care unit
  • nurse
  • physician

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Perspectives of physicians and nurses regarding end-of-life care in the intensive care unit. / Festic, Emir; Wilson, Michael; Gajic, Ognjen; Divertie, Gavin D.; Rabatin, Jeffrey T.

In: Journal of Intensive Care Medicine, Vol. 27, No. 1, 02.2012, p. 45-54.

Research output: Contribution to journalArticle

@article{37d48d339e7e4dfc8eb425535072e262,
title = "Perspectives of physicians and nurses regarding end-of-life care in the intensive care unit",
abstract = "Context: The delivery of end-of-life care (EOLC) in the intensive care unit (ICU) varies widely among medical care providers. The differing opinions of nurses and physicians regarding EOLC may help identify areas of improvement. Objective: To explore the differences of physicians and nurses on EOLC in the ICU and how these differences vary according to self-reported proficiency level and primary work unit. Design: Cross-sectional survey of 69 ICU physicians and 629 ICU nurses. Setting: Single tertiary care academic medical institution. Results: A total of 50 physicians (72{\%}) and 331 nurses (53{\%}) participated in the survey. Significant differences between physicians and nurses were noted in the following areas: ability to safely raise concerns, do not resuscitate (DNR) decision making, discussion of health care directives, timely hospice referral, spiritual assessment documentation, utilization of social services, and the availability of EOLC education. In every domain of EOLC, physicians reported a more positive perception than nurses. Additional differences were noted among physicians based on experience, as well as among nurses based on their primary work unit and self-reported proficiency level. Conclusions: Even with an increased focus on improving EOLC, significant differences continue to exist between the perspectives of nurses and physicians, as well as physicians among themselves and nurses among themselves. These differences may represent significant barriers toward providing comprehensive, consistent, and coordinated EOLC in the ICU.",
keywords = "attitude of health personnel, end of life, intensive care unit, nurse, physician",
author = "Emir Festic and Michael Wilson and Ognjen Gajic and Divertie, {Gavin D.} and Rabatin, {Jeffrey T.}",
year = "2012",
month = "2",
doi = "10.1177/0885066610393465",
language = "English (US)",
volume = "27",
pages = "45--54",
journal = "Journal of Intensive Care Medicine",
issn = "0885-0666",
publisher = "SAGE Publications Inc.",
number = "1",

}

TY - JOUR

T1 - Perspectives of physicians and nurses regarding end-of-life care in the intensive care unit

AU - Festic, Emir

AU - Wilson, Michael

AU - Gajic, Ognjen

AU - Divertie, Gavin D.

AU - Rabatin, Jeffrey T.

PY - 2012/2

Y1 - 2012/2

N2 - Context: The delivery of end-of-life care (EOLC) in the intensive care unit (ICU) varies widely among medical care providers. The differing opinions of nurses and physicians regarding EOLC may help identify areas of improvement. Objective: To explore the differences of physicians and nurses on EOLC in the ICU and how these differences vary according to self-reported proficiency level and primary work unit. Design: Cross-sectional survey of 69 ICU physicians and 629 ICU nurses. Setting: Single tertiary care academic medical institution. Results: A total of 50 physicians (72%) and 331 nurses (53%) participated in the survey. Significant differences between physicians and nurses were noted in the following areas: ability to safely raise concerns, do not resuscitate (DNR) decision making, discussion of health care directives, timely hospice referral, spiritual assessment documentation, utilization of social services, and the availability of EOLC education. In every domain of EOLC, physicians reported a more positive perception than nurses. Additional differences were noted among physicians based on experience, as well as among nurses based on their primary work unit and self-reported proficiency level. Conclusions: Even with an increased focus on improving EOLC, significant differences continue to exist between the perspectives of nurses and physicians, as well as physicians among themselves and nurses among themselves. These differences may represent significant barriers toward providing comprehensive, consistent, and coordinated EOLC in the ICU.

AB - Context: The delivery of end-of-life care (EOLC) in the intensive care unit (ICU) varies widely among medical care providers. The differing opinions of nurses and physicians regarding EOLC may help identify areas of improvement. Objective: To explore the differences of physicians and nurses on EOLC in the ICU and how these differences vary according to self-reported proficiency level and primary work unit. Design: Cross-sectional survey of 69 ICU physicians and 629 ICU nurses. Setting: Single tertiary care academic medical institution. Results: A total of 50 physicians (72%) and 331 nurses (53%) participated in the survey. Significant differences between physicians and nurses were noted in the following areas: ability to safely raise concerns, do not resuscitate (DNR) decision making, discussion of health care directives, timely hospice referral, spiritual assessment documentation, utilization of social services, and the availability of EOLC education. In every domain of EOLC, physicians reported a more positive perception than nurses. Additional differences were noted among physicians based on experience, as well as among nurses based on their primary work unit and self-reported proficiency level. Conclusions: Even with an increased focus on improving EOLC, significant differences continue to exist between the perspectives of nurses and physicians, as well as physicians among themselves and nurses among themselves. These differences may represent significant barriers toward providing comprehensive, consistent, and coordinated EOLC in the ICU.

KW - attitude of health personnel

KW - end of life

KW - intensive care unit

KW - nurse

KW - physician

UR - http://www.scopus.com/inward/record.url?scp=84863420924&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863420924&partnerID=8YFLogxK

U2 - 10.1177/0885066610393465

DO - 10.1177/0885066610393465

M3 - Article

C2 - 21257636

AN - SCOPUS:84863420924

VL - 27

SP - 45

EP - 54

JO - Journal of Intensive Care Medicine

JF - Journal of Intensive Care Medicine

SN - 0885-0666

IS - 1

ER -