The involvement of intensive care nurses in end-of-life decisions: a nationwide survey

Objective To investigate the prevalence and predictors of intensive care nurses’ active involvement in end-of-life (EOL) decisions. Design and setting A survey of intensive care nurses from 36 intensive care units (ICUs) in New Zealand. Measurements and results A total of 611 ICU nurses from 35 ICUs responded to this survey. The response rate was estimated to be between 43% and 81%. Seventy-eight percent of respondents reported active involvement in EOL decisions, especially the senior nurses (level IV vs. I nurses, OR 7.9; nurse educators vs. level I nurses, OR 4.3). Asian (OR 0.2) and Pacific Islander nurses (OR 0.2) were less often involved than European nurses. Sixty-eight percent of respondents preferred more involvement in EOL decisions, and this preference was associated with the perception that EOL decisions are often made too late (OR 2.2). Sixty-five percent believed their active involvement in EOL decisions would improve nursing job satisfaction. Conclusions Most ICU nurses in New Zealand reported that they are often involved in EOL decisions, especially senior and European nurses.