| Learning Objective #1: describe the extent to which nurse practitioners discuss end-of-life treatment decisions with patients and/or their representatives. | |||
| Learning Objective #2: summarize under what circumstances nurse practitioners discuss end-of-life treatment decisions with patients and/or their representatives. |
This descriptive survey examined NP practices with respect to end-of-life and advance directive discussions. Tools were developed to determine if NPs provided information that could be used in planning and, if so, under what circumstances.
A systematic random sample of 600 nurse practitioners in California, USA were surveyed. Responses from 297 NPs representing a wide variety of practice areas were grouped according to demographic information. Data indicated that nearly two-thirds of the NPs (64%) discussed end-of-life and advance directives; however, of those, only 4% discussed them routinely. Respondents discussed these issues with healthy patients less than 10% of the time and with patients older than 65 only 11% of the time. There were significant differences in discussions based on NP specialty (p = .0006) and practice setting (p =.00002). Nurse practitioners function in many settings, providing health promotion and disease prevention. Results of this study support the value of early end-of-life and advance directive planning between patients and NPs and contribute to the advocacy role. There is a need for increased education regarding attitudes toward the subject as well as barriers to these discussions by NPs. Further study is warranted.