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Caring for patients at the end of life in intensive care units
  1. Victoria Kendall, Clinical Skills Tutor
  1. Victoria Kendall is Clinical Skills Tutor, Undergraduate Centre, Manchester Royal Infirmary. At the time of writing she was Sister, Intensive Care Unit, Manchester Royal Infirmary. Email: Victoria.Kendall{at}


Intensive care units (ICUs) have developed over the last 40 years. Patients cared for in intensive care are now sicker than previously. Not all survive. Nationally, average mortality rates in ICUs can be 20–30%. In the technical ICU environment, staff members require education and training in end-of-life care decision-making, recognition of dying and patient/family care. Literature suggests that ICU patients whose management has shifted from curative to palliative, experience inconsistent quality of care. Furthermore, when intervention and cure are seen as the ‘norms’, systematic change in practitioners’ attitude and behaviour is required at the end of life. Central funding is available to support the NHS End of Life Care Programme, which aims to promote high-quality end-of-life care for all patients, regardless of diagnosis. This article examines ICU decision-making in relation to end-of-life care and ICU nurses’ experiences of caring for dying patients. It proposes the use of an integrated care pathway for patients dying in critical care environments. Conflicts of interest: none

  • Communication
  • Professional conflict
  • End-of-life care
  • Intensive care
  • Liverpool Care Pathway for
  • the Dying Patient

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