End-of-Life Care: A Dignified Death

In ICU patients, haemodynamic systems are disordered, from turbulence in fluids, the erratic flows of vascular systems to the arrhythmic writhing of the heart. At their cellular, organ, total body, emotional, mental, familial and social levels, patients admitted to the ICU lose the systematic routine of their lives and face chaotic complexities. Stability is an emergent property of complex organ systems that characterises complex adaptive processes and it is essential to living organisms. Nurses are the clinicians closest to the patients in daily monitoring, assessing, intervening with treatments and evaluating the outcomes. They evaluate all the physiological abnormalities, emotional instabilities (delirium, delusions, non-sleep rhythms, and agitation) as well as spiritual assessment regarding religious beliefs, cultural rituals and family relationships. ICU nurses target their interventions to optimise patient homeostasis as well as family support and stability. There is a need to examine the tools used when assessing life threatening and end-of-life situations from the patients, the ICU team or family perspective. During routine care delivery, data is collected from numerous sources, critical thinking and emotional intelligence are used to mitigate and advocate for patient and family best interests. In the literature, there are a multitude of scientific findings demonstrating nursing assessment, interventions and evaluations and eventually they integrate the multifaceted scope of their care during life-threatening situations throughout the transition from ICU treatment to the dignified care at the end-of-life. Thus a successful ICU discharge for some patients is a dignified death.