In end-of-life care, which combination best reflects the nurse's role across settings?

• A. Routinely continue aggressive care without discussing goals.
• B. Exclude family input in care planning.
• C. Delay advance care planning until after death.
• D. Coordinate care, discuss goals of care, advance care planning, symptom management, and family support.

Answer: (D)

The main idea is that end-of-life nursing care is about coordinating and communicating across settings to honor patient goals, relieve suffering, and support families. A nurse acts as a consistent link among the interdisciplinary team, the patient, and loved ones as care moves between hospital, home, and hospice. This involves proactive discussions about goals of care, initiating advance care planning so patient preferences are documented, and ensuring symptom management is tailored to comfort and quality of life. Supporting families—through education, emotional support, and bereavement resources—is also essential, helping them navigate decisions and the care transition with confidence.

This comprehensive approach is preferred because it centers on patient values, reduces unnecessary or unwanted interventions, and maintains continuity of care across settings. Other approaches miss key elements: insisting on aggressive care without goals discussion can lead to treatments that don’t align with patient wishes; excluding family input ignores crucial support and shared decision-making; delaying advance care planning until after death is not feasible and leaves preferences undocumented and unenacted.