The number of persons on hemodialysis therapy continues to increase annually. For many of these patients, end-of-life (EOL) discussions have not taken place until a major medical change or crisis occurs. Additionally, the patient is often unable to make medical decisions independently. Nephrology nurses have the opportunity and responsibility to assist patients in the EOL decision-making process, including treatment withdrawaL Conversations occurring early in the patient's course of hemodialysis encourage shared decision making between the nurse and patient. The end result may be quality EOL care incorporating the patients' needs and desires.
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