Nurses are strapped at the frontiers of the healthcare industry, offering comfort, skilled care, compassion for families and patients. Other than monitoring patient health, nurses are essential in ensuring that patients who are breathing their last breaths die in the place of their choice. In straightforward terms, it’s known as the End-of-Life, EOL, decision making. Since patients and their families are often in a state of misery, they lack proper decision-making capacity. That’s when nurses come in to break the bad news. Further, it’s harrowing for both healthcare professionals and family members to give up on therapeutic care.

If you’ve ever had a loved one in hospice, you must know how critical nurses are to the entire process. Nurses are the liaisons and communicators between the deathbed patient, their family, and the healthcare team. On the other hand, there is a false belief running around everyone’s minds that offering end-of-life care is the role of palliative care teams – that’s not the case. It’s every nurse’s role, whether with homeless people, in the prison sector, or care homes; nurses are responsible for fulfilling a dying patient’s wish by coordinating as much as possible.

Here’s everything you need to know about a nurse’s role in the end-of-life decision-making process.

The Do’s of End Of Life Decision Making 

Catering to a failing patient isn’t easy. There’s a list of things a nurse has to do to successfully offer support to a patient who’s about to leave this world.

Furthermore, if you’re keen on doing whatever it takes to provide commendable care to your patients, but your rank doesn’t allow you, we have a solution. For starters, you need a leg up on your education. You can apply for a masters of nursing online; it is a wonderful opportunity for a nurse who wants to do more than memorize patient charts.

Coming back to the topic, when providing EOL care, nurses must:

  • Listen to patients
  • Treat patients compassionately 
  • Meet and identity the communication needs of every individual
  • Recognize when a patient may be entering the last hours/days of life
  • Seek further advice if necessary
  • Keep the patient up to date with any alterations or possible miracles in condition.
  • Look after yourself and seek counseling if needed.

Now that the key points are covered let’s move to the roles and strategies.

The Important Roles and Strategies of a Nurse in EOL Decision-Making 

Providing Updates and Mediating 

One of the most vital roles of a nurse during hard times is facilitating information between family members and the healthcare squad. The strategies involved in executing this role get compressed into three categories: giving information to family members, giving information to physicians, and mediating between them.

Being the Supporter 

Another mandatory yet challenging role of a nurse is to offer support. Now, the form of support can be different. It can either get done by building a trustworthy bond with the family members to prepare them for the EOL decision-making process. Or, it can be done by empathizing with the patients, physicians, and family members. Without this, the patients and family members may feel lost and devastated. Worst-case scenario, they may not even understand the medical jargon you’re bound to list. Therefore, offering a comforting shoulder is necessary.

Advocating for the Family and Patient 

Nurses advocate relatives on behalf of patients regarding EOL decision-making. They use a gentle approach while conveying the final days of a patient’s life. During this time, the patient’s family members may demand a last-minute cure, which is mainly in the form of “Isn’t there anything you can do to save his/her life?”

Since this is a susceptible time for both the family and patient, nurses assist by clarifying treatment priorities and help discover a functional plan.

They clarify care goals, making the family consider what the patient would’ve wanted from the start. Other than that, they may explain the implications of the decision. In short, nurses facilitate the decision-making process by presenting a crystal-clear picture of what was happening, counseling the family members to keep the facts in mind. At the end of the day, it’s all about accepting the inevitability of death.

Family and Patient Outcomes 

As we all know, there are consequences to every action. That said, nurses recognize the potential effect of EOL decision-making on the family and patient. Through their roles in communicating and allowing patients to remain sane, nurses can elevate the likelihood of a good death.

According to the studies, nurses believe that the strategies they use help family members accept that a person is dying. They do so by bringing them to “readiness” and helping them to “let go.” In return, the family members find the involvement of nurses beneficial, so the decision-making process becomes satisfactory.


So it’s pretty evident that nursing isn’t a cakewalk. These roles and strategies of a nurse in the EOL decision-making process only scratch the surface. It takes a lot of might to stand face-to-face with a patient and tell them that the end is near. Only a nurse can advocate for a patient, care for them, and be there during their last hours. Nurses here’s to you for taking the load of “bad news” on your shoulders!

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