The dying patient in the intensive care unit: assisting the family in crisis

Critically ill patients belong to larger phenomenologic systems, their families. What affects one member affects other system members. Nursing care requires meticulous observation and assessment of family concerns, understanding of clinical events, and practical experience to achieve positive outcomes even if a death occurs. It seems easy to dismiss the family from the clinical and technical matters of the critical care unit, especially when much nursing energy goes into operating peripheral machinery, performing tasks, and pursuing ever-changing patient-centered goals. The following case study attempts to redefine and redirect the focus of what "patient-centered" means to include the nurse, the patient, and the family in the meaning of the core of family-centered care.