Nurses and End of Life Medical Decisions

Perhaps one of the most important issues that people in the medical profession will face in their careers will be related to advanced care directives. Last week, hundreds of graduate nursing students and medical professionals in Charlottesville, Virginia convened at the Center for Global Health for a flash seminar on advance care directives – or issues related to an individual’s living will and the medical decisions to be made in the event that an individual becomes medically incapable of actively participating in specific health care decisions.

For graduate nursing students Karen Moss, Julia Truelove, and Michael Swanberg, the issue of “end-of-life” conversations is arguably the most important and expensive conversations that the nursing profession “needs to have.”

Facilitators at the flash seminar talked about how important it is to make decisions about advanced care as early in life as possible. Everyone acknowledges that it is not a pleasant topic of conversation and can seem wholly unnecessary for people who are in their 20s and 30s. However, Moss points out that anyone over the age of 18 “needs to be thinking about this decision” and says that she and her graduate nursing colleagues are well aware of the common misconceptions regarding what exactly advanced care directives are all about and the overlap between the legal and medical elements of this important issue.

One problem, according to Swanberg, is that the culture in America is one that encourages people to spend money on medical procedures and prescriptions that have a high likelihood of not working at the end of life. Swanberg says that Americans “never talk about death, so how are we going to talk about advanced directives when we don’t acknowledge the possibility?”

All three of the graduate nursing students say that while it is the responsibility of the patient to take responsibility of his or her own health care, it is indeed the responsibility of nurses and other medical professionals to properly administer that care.