Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Practice Recommendations for Care and Management at the End of Life
3.1    Nurses are knowledgeable about pain and symptom management interventions to enable individualized care planning.
3.2    Nurses advocate for and implement individualized pharmacologic and non-pharmacologic care strategies.
3.3    Nurses educate and share information with individuals and their families regarding:
    • reconciliation of medications to meet the individual’s current needs and goals of care;
    • routes and administration of medications;
    • potential symptoms;
    • physical signs of impending death;
    • vigil practices;
    • self care strategies;
    • identification of a contact plan for family when death has occurred; and
    • care of the body after death.
3.4   Nurses use effective communication to facilitate end of life discussions related to:
    • cultural and spiritual values, beliefs and practices;
    • emotions and fears;
    • past experiences with death and loss;
    • clarifying goals of care;
    • family preference related to direct care involvement;
    • practical needs;
    • informational needs;
    • supportive care needs;
    • loss and grief; and
    • bereavement planning.