Center to Advance Palliative Care

When considering palliative care in the ICU I would recommend that you first look at what your current relationship is with the ICU and then build from there. Looking at the culture in your ICU, your institution and with your physicians can help chart the course for your intervention. There are different models for collaboration and involvement in the ICU that can range from having a collaborative process that leads to development of standardized policies and and protocols to automatic referrals to a trigger system. Where you start will need to reflect where you are in the relationship and current involvement in the ICU's. There is an article that you may find helpful: Campbell ML, Guzman JA. Impact of a proactive approach to improve end-of-life care in a medical ICU. Chest, 2003; 123:266-127.
One of the modules for PCLC II curriculum that has been developed by the Palliative Care Leadership Centers was Palliative Care in the ICU. Contact a PCLC for more information about this learning/training opportunity. It has been established that palliative involvement in the ICU can be a win-win situation for all parties. In this tough economic time and time of potential health care reform the discussion becomes even more relevant. Sharol Herr, RN, MSEd, CHPN, Nurse Clinician/Education Coordinator; Mount Carmel Health Palliative Care Leadership Center; Columbus, Ohio.