The registered nurse: perceptions about advance directives

The driving force behind mandates from both the American Nurses' Association and the American Medical Association is an expectation that doctors and nurses will act as advocates for the participation of the patient in end-of-life treatment decisions. This mandate assumes that both groups are knowledgeable about advance directives and can advise patients on these. Both groups are enjoined not only to facilitate the expression of the patient's wishes but also scrupulously to honor these. The literature suggests that, despite their professional mandate, nurses may feel uncertain about the legal, moral, and ethical obligations surrounding their participation in this enormously significant aspect of patient care. This study focuses on the perception of the dilemma by a sample of registered nurses at a large southeastern university medical center.