Palliative Social Work in the Intensive Care Unit

Abstract

AbstractThe modern intensive care unit (ICU) is one setting in which life and death hang in the balance. Patients are in critical condition or at risk of decompensating quickly and require close monitoring and complex medications to preserve organ function and ameliorate pain. Patients are also often sustained on life support: machines that supply nutrition, maintain breathing, and stand in for failing organs such as kidneys or hearts. Care is managed by interdisciplinary teams of medical professionals (social workers, nurses, physician assistants, nurse practitioners, pharmacists, and doctors) led by physician intensivists, with the orienting goal of the preservation of life. Yet, despite the strenuous efforts of the medical team, death is quite common. Patients and families in the ICU need accurate information, time to process clinical information, and the opportunity to discuss and explore the values they hold that inform the plan of care, particularly when faced with decision-making around advanced life support and end-of-life care.