Rosa William E, Ferrell Betty R, Wiencek Clareen
William E. Rosa is a Robert Wood Johnson Foundation Future of Nursing Scholar, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.
Betty R. Ferrell is a professor and the Director of Nursing Research, City of Hope National Medical Center, Duarte, California.
Crit Care Nurse. 2020 Dec 1;40(6):e28-e36. doi: 10.4037/ccn2020946.
The coronavirus disease 2019 pandemic has led to escalating infection rates and associated deaths worldwide. Amid this public health emergency, the urgent need for palliative care integration throughout critical care settings has never been more crucial.
To promote palliative care engagement in critical care; share palliative care resources to support critical care nurses in alleviating suffering during the coronavirus disease 2019 pandemic; and make recommendations to strengthen nursing capacity to deliver high-quality, person-centered critical care.
Palliative and critical care literature and practice guidelines were reviewed, synthesized, and translated into recommendations for critical care nursing practice.
Nurses are ideally positioned to drive full integration of palliative care into the critical care delivery for all patients, including those with coronavirus disease 2019, given their relationship-based approach to care, as well as their leadership and advocacy roles. Recommendations include the promotion of healthy work environments and prioritizing nurse self-care in alignment with critical care nursing standards.
Nurses should focus on a strategic integration of palliative care, critical care, and ethically based care during times of normalcy and of crisis. Primary palliative care should be provided for each patient and family, and specialist services sought, as appropriate. Nurse educators are encouraged to use these recommendations and resources in their curricula and training. Palliative care is critical care. Critical care nurses are the frontline responders capable of translating this holistic, person-centered approach into pragmatic services and relationships throughout the critical care continuum.
2019年冠状病毒病大流行导致全球感染率不断攀升以及相关死亡人数增加。在这一公共卫生紧急情况中，在整个重症监护环境中整合姑息治疗的迫切需求从未像现在这样至关重要。
促进在重症监护中开展姑息治疗；分享姑息治疗资源，以支持重症监护护士在2019年冠状病毒病大流行期间减轻患者痛苦；并提出建议以加强护理能力，提供高质量的、以患者为中心的重症监护。
对姑息治疗和重症监护的文献及实践指南进行了回顾、综合，并转化为重症监护护理实践的建议。
鉴于护士基于关系的护理方法以及他们的领导和倡导作用，护士处于推动将姑息治疗全面整合到所有患者（包括2019年冠状病毒病患者）的重症监护中的理想位置。建议包括促进健康的工作环境，并根据重症监护护理标准优先考虑护士的自我护理。
护士应在正常时期和危机时期专注于姑息治疗、重症监护和基于伦理的护理的战略整合。应为每位患者及其家属提供初级姑息治疗，并在适当时寻求专科服务。鼓励护理教育工作者在其课程和培训中使用这些建议和资源。姑息治疗即重症监护。重症监护护士是能够在整个重症监护连续过程中将这种整体的、以患者为中心的方法转化为实际服务和关系的一线响应者。
