Attitudes of nursing staff towards involvement in medical end-of-life decisions: A national survey study

Objectives

To investigate nursing staff attitudes towards involvement and role in end-of-life decisions (ELDs) and the relationships with sociodemographic and work-related characteristics.

Methods

Survey study among nationally representative Dutch research sample consisting of care professionals. Nursing staff working in hospitals, home care, nursing homes or homes for the elderly were sent ELD-questionnaire.

Results

Response: 66% (n = 587). Most respondents had been involved in ELD. Three quarters wanted to be involved in whole ELD process; 58% agreed that decisions to withhold/withdraw treatment ought to be discussed with the nurses involved; 64% believed patients would talk rather to nurses than physicians; 72% thought physicians are usually prepared to listen to nurses’ opinions. Hospital and highly educated nursing staff indicated relatively more often that they want to be involved in ELD.

Conclusion

Majority of nursing staff want to be involved in ELD. Work setting and educational level are determining factors in attitudes of nursing staff regarding involvement in ELD.

Practice implications

Awareness on the important role nurses have and want to have in ELD should be raised, and taken into account in trainings on end-of-life care for nurses and physicians and development of guidelines for communication about ELD between patients, nursing staff and physicians.