End of life/Hospice discussion on admittance to unit

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i am a nursing student (pre-licensure bsn) and have been impressed by the critical care nurses i've been around but also disturbed by some of the patients i've seen. some patients are clearly sustained by technology far past what makes sense. it seems that they are subjected to the remainder of their life being in pain and extreme discomfort. often, it seems that the patient is ready to go, but the family is unwilling to let go. i am wondering what experienced nurses believe would help in this regard. my thoughts are that some mechanism should be in place to have an open discussion with the family and/or patient about death and/or hospice care on admittance to the unit. i'm not sure how to do this, but many patients admitted to a ccu or icu are in a position where death (or at least a severely diminished quality of life) is a real possibility. death is not always a terrible alternative, especially when people understand how hospice can help make dying as dignified and comfortable as possible. i am a little biased as i am doing my senior rotation in a hospice setting. looking forward to your thoughts!

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