SUPPORT Revisited: The Nurse Clinician's Perspective

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SUPPORT (the Study To Understand Prognoses and Preferences for Outcomes and Risks of Treatment) has brought to the fore the complexities involved in end-of-life decision making. The article addresses the use of aggressive treatment in patients with poor prognoses, patient preferences, and the effects of advance directives on the care of the seriously ill patient. Discussion of end-of-life decisions is recommended among the patient, family members, and physician before the hospitalization, as is improved exposure to alternatives to aggressive treatment, such as hospice and terminal care units. Key words: advance directives, comfort, death and dying, decision making, do not resuscitate orders, end-of-life issues, nurse clinician, patient preferences, prognosis, SUPPORT

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