Breaking bad news and discussing goals of care in the intensive care unit.

The intensive care unit is a high-stakes environment in which nurses, including advanced practice registered nurses (APRNs), often assist patients and families to navigate life and death situations. These high-stakes situations often require discussions that include bad news and discussions about goals of care or limiting aggressive care, and APRNs must develop expertise and techniques to be skilled communicators for conducting these crucial conversations. This article explores the art of communication, the learned skill of delivering bad news in the health care setting, and the incorporation of this news into a discussion about goals of care for patients.

Comprehensive guideline for care of patients with heart failure.

Heart failure (HF) is a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood. More than 5.1 million people are living with HF in the United States today.

Leadership in action: creating a change in practice.

Change is common and important in improving patient outcomes in the current healthcare market. Because of the tremendous increase in credible research and publication of research findings, clinicians now use evidence-based findings to guide their practice. The rapid changes in the healthcare environment require effective leaders that can implement change strategies to improve patient outcomes.