Lenora Smith

Lenora Smith

University of Alabama in Huntsville, USA

Title: Do Nurses use evidence-based information to guide desicion making at the end of life?


Lenora Smith, PhD, RN is an Assistant Professor in the College of Nursing and teaches at the undergrate level and in the doctor of nursing practice program. She has experience in gerontology and home health and her research area focuses on palliative care, end-of-life issues, and interventions for decreasing or alleviating symptoms in individuals with dementia. She is active on several faculty and university committees, as well as several nursing professional organizations.


Artificial nutrition and hydration has become a complex and an ethical issue for the dying. There are confusing opinions as to the whether ANH is of benefit to dying individuals, which results in inconsistent communication by health care providers. In turn, inconsistencies in information from their health care providers result in confusion for the patients and families having to make decisions regarding ANH. These decisions can then increase suffering for the dying individual. Decisions regarding ANH become challenging when the persons making the decisions are not well informed of the consequences or the risks involved, or even the reason why ANH should be initiated or withheld. Todd, Rosendaal, Duregon, & Verhoef (2005) found in their mixed-method study that nurses feel they have a role in the ANH decision-making process, for example as educator. In addition, Pasman, et al. (2004) found that nurses spend more time with the patients than physicians and develop a more trusting relationship with the patients and their families. Evidence shows that nurses lack evidence-based knowledge of ANH and pass these misperceptions and inaccurate information to patients and families, who then make uninformed decisions. This presentation will discuss the evidence of ANH in dying people and how evidence-based information is pertinent to informed decision making for dying individuals and their families. It will address how utilizing evidence-based information can decrease or alleviate more suffering for the dying.

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