Integration of critical care and palliative care at end of life

Br J Nurs. 2004 Feb;13(3):132-6, 138-9. doi: 10.12968/bjon.2004.13.3.12109.


End-of-life care in the critical care environment suffers from a lack of clarity and uncertainty. Critical care nurses may often feel torn between wanting to do everything possible to sustain a patient's life and wanting to do what is in the patient's best interests. Reframing the focus of care from cure to comfort can be an uncomfortable shift for nurses, who may not be in control of when the change of goals takes place. Good end-of-life care should be a core competency for all nurses and it is our responsibility to ensure that decisions to forgo life-sustaining treatment in critical care are appropriate and timely. Futility, conflict and resources all factor in such decisions. Nurses must ensure the transition from cure to comfort does not emphasize a dichotomy between palliative care and critical care but instead focuses on the provision of the best possible end-of-life care.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Benchmarking
  • Clinical Competence / standards
  • Conflict, Psychological
  • Continuity of Patient Care / ethics
  • Continuity of Patient Care / organization & administration*
  • Cooperative Behavior
  • Critical Care / ethics
  • Critical Care / organization & administration*
  • Decision Making, Organizational
  • Humans
  • Interprofessional Relations
  • Leukemia, Myeloid, Acute / nursing
  • Male
  • Medical Futility
  • Models, Nursing
  • Nurse's Role*
  • Organizational Objectives
  • Palliative Care / ethics
  • Palliative Care / organization & administration*
  • Patient-Centered Care / organization & administration
  • Terminal Care / ethics
  • Terminal Care / organization & administration*