Abstract
Patients present to the emergency department with critical and complex medical conditions that require a broad scope of medicine to achieve patient outcomes. Emergency medicine physicians are recognizing the importance and positive outcomes that arise when palliative care teams are consulted in the emergency room. Today, medical schools, residency programs, and emergency departments are requiring palliative care curriculum apart of their education. However, there continues to be a gap in early initiation of palliative care in emergency medicine. Nurse practitioners are becoming pivotal in the emergency department, and patients are considering them key providers in their medical journey. The role of an advanced practice nurse in an emergency room may be optimal for the early onset of palliative care consultation. This manuscript examines current knowledge that explores the background of palliative care, the current practice in the emergency department, the positive outcomes and gaps that still exist today, and the increasing role of an advanced practice nurse in the emergency room and their impact on palliative care initiation.
Highlights
Case StudyMr Smith, a 75-year-old man, has been admitted multiple times to the critical care unit because of his recurring COPD and heart failure exacerbations
As the population ages, many patients will present to the Emergency Department (ED) with serious and complex medical conditions that require a broad scope of medicine to achieve patient outcomes [2]
With the start of adding palliative care (PC) curriculum into advanced practice nurse programs, and the role Nurse Practitioner (NP) have in healthcare, this may be the start of solving the lack of PC initiation that occurs in emergency medicine
Summary
Mr Smith, a 75-year-old man, has been admitted multiple times to the critical care unit because of his recurring COPD and heart failure exacerbations. He remains a full code, and his wife continues to tell the physicians he “wants everything done”. As Mr Smith continued aggressive care in the ICU, one of the critical care nurses caring for him suggested a palliative care consultation. The palliative care team was consulted and was able to meet with the patient and his wife to learn about the couple’s values, beliefs, and goals of care. Patients’ decisions after palliative care consultations are not predictable, but there is evidence that indicates palliative care teams help patients maximize their quality of life, improve their pain, and in some instances help patients live longer [1]
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