Strategies to improve end-of-life care in the intensive care unit.

Death is a frequent occurrence in the intensive care unit (ICU). Critical care nurses often feel unprepared to deliver expert end-of-life care. This article proposes specific strategies for critical care nurses to improve the delivery of end-of-life care in the ICU. Critical care nurses can examine beliefs about death; recognize that cure and palliative care coexist; create an environment that supports dying as well as curing; improve communication among providers, patients, and families; provide "small things that make a big difference" at the end-of-life; and locate and utilize support for improving end-of-life care.