Moral Distress in PICU and Neonatal ICU Practitioners

In this single-center, cross-sectional study, we found that moral distress is present in PICU and neonatal ICU health practitioners and is correlated with burnout, uncertainty, and feeling unsupported. The main outcome was... read more

Moral Distress in PICU and Neonatal ICU Practitioners

Under-reporting of End-of-life Decisions in Critical Care Trials: A Call to Modify CONSORT Statement

Under-reporting of End-of-life Decisions in Critical Care Trials: A Call to Modify CONSORT Statement... read more

Under-reporting of End-of-life Decisions in Critical Care Trials: A Call to Modify CONSORT Statement

Burn Till You’re Out

When using the technical definition of burnout: "The reduction of a fuel to nothing", it clearly describes the state of being of the few people that I have met who are having a burnout. The problem is huge and almost... read more

Burn Till You’re Out

Critical care at the end of life: a population-level cohort study of cost and outcomes

Despite the high cost associated with ICU use at the end of life, very little is known at a population level about the characteristics of users and their end of life experience. In this study, our goal was to characterize... read more

Critical care at the end of life: a population-level cohort study of cost and outcomes

Persistent Gaps in Use of Advance Directives Among Nursing Home Residents Receiving Maintenance Dialysis

Patients with end-stage renal disease receiving dialysis have a symptom burden and prognosis comparable to patients with incurable cancer. They frequently and increasingly receive intensive procedures near the end of life.... read more

Persistent Gaps in Use of Advance Directives Among Nursing Home Residents Receiving Maintenance Dialysis

How to Ensure Your Medical Wishes Are Followed if You’re Critically Ill and Incapacitated

It happens every day in the intensive care units of hospitals throughout the country: Physicians ask the loved ones of someone kept alive by a ventilator and other medical devices whether the patient would want to live hooked... read more

How to Ensure Your Medical Wishes Are Followed if You’re Critically Ill and Incapacitated

We're Bad at Death. Can We Talk?

Despite growing recognition that more care isn't necessarily better care, particularly at the end of life, many Americans still receive an enormous dose of medicine in their final days. On average, patients make 29 visits... read more

We're Bad at Death. Can We Talk?

Integrating Advance Care Planning into Practice

Advanced respiratory diseases progress over time and often lead to death. As their condition worsens, patients may lose medical decision making ability. Advance care planning (ACP) is a process in which patients receive information... read more

Integrating Advance Care Planning into Practice

Early Palliative Care in Advanced Illness

As the on-call pulmonary critical care fellow, I listened to a family member plead with me to "do right by Mama." The emergency department team consulted me for possible intensive care unit (ICU) admission on a... read more

Early Palliative Care in Advanced Illness

Pricey Technology Is Keeping People Alive Who Don’t Want to Live

As an ICU physician, I’ve used technologies like breathing machines and feeding tubes to save lives that would have been lost just a few decades earlier. But I’ve also seen the substantial costs, both human and financial,... read more

Pricey Technology Is Keeping People Alive Who Don’t Want to Live

Learning to talk about death should start early in doctors' careers

At first glance, physicians’ poor understanding of death and the process of dying is baffling, since they are supposed to be custodians of health across the lifespan. Look deeper, though, and it may reflect less the attitudes... read more

Learning to talk about death should start early in doctors' careers

Never Stop Caring

I read with interest the piece by Wilson et al regarding their examination of end-of-life care patterns in hospitalized patients on their vascular surgery practice in Oregon. I applaud the authors for examining their practices... read more

Never Stop Caring

5 ways to improve care at the End of Life

These days it is much more common for people to live longer with multiple chronic conditions, and we have the technology to prolong life as death approaches. End-of-life care is fragmented, intensive, and costly - and patients’... read more

5 ways to improve care at the End of Life

Experiences and Expressions of Spirituality At the End of Life in the ICU

Family members and clinicians consider spirituality an important dimension of end-of-life care. The 3 Wishes Project invites and supports the expression of myriad forms of spirituality during the dying process in the ICU.... read more

Experiences and Expressions of Spirituality At the End of Life in the ICU

How nurses support families of ICU patients towards the end of life

Researchers gathered evidence on how nurses care for patients and their families in intensive care when life-sustaining treatment is withdrawn. The included studies explored the care of the family before, during and after... read more

How nurses support families of ICU patients towards the end of life