Abstract
The purpose of this study was to clarify how critical care nursing specialist (CCNS) coordinates ethical issues for terminally ill patients in the intensive care unit. A semi-structured interview was conducted with 10 CCNSs and the results were analyzed by both qualitative and inductive methods.
The analysis revealed 13 categories such as "to predict the path to the terminal phase and assess the limit of active treatment", "to try to understand the patient's will even when it is difficult to confirm it", "to share a burden of sole decision making with a family member", "to minimize the regret of a family member who acts as a surrogate decision-maker", "to ease suffering of family members who cannot give up recovery", "to make facing death as desirable as possible as an extension of intensive care", "to understand the heavy responsibility of doctors who are required to make a difficult decision and avoid confrontation with them", and "to take care of disconsolate feelings of medical professional who lose patients".
CCNSs are considered to have played a role in patient advocacy, surrogate decision-making support and grief care for families of patients, help to patients and their families to realize their desire to have a "good death", and building a foundation among medical team members to work as a team for end-of-life care.
