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PICO: Question: In patients requiring palliative care (P), does having nurses introduce palliative care early in the diagnosis (I) compared to patients who do not receive palliative care (C) have better outcomes and better quality of life (O)?"

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Somewhere Over The Rainbow - Instrumental

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lyrics: Somewhere over the rainbow Way up high There's a land that I heard of once in a lullaby Somewhere over the rainbow Skies are blue And the dreams that you dare to dream really do come true Someday I'll wish upon a star And wake up where the clouds are far behind me Where troubles melt like lemon drops Away above the chimney tops That's where you'll find me Somewhere over the rainbow Blue birds fly Birds fly over the rainbow Why then oh why can't I?

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Examination of the nurses’ current roles and participation regarding the selected issue.

no in depth conversations

discussing death

understanding palliative care

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What are the challenges or barriers for nurse involvement in the issue?

lack of understanding palliative care

lack of education & training

ethical dilemmas/bias

afraid to bring up subject

patients family members

philosophy change

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When to start the conversation

Nurse education

Nurses Role

Respecting Patients Wishes

Benefits

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Utilizing Jean Watson's theory of caring

Examine personal beliefs

Education and training

Use evidence based practice

Set of prompt to start discussion

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Photo retrieved from (spiritualpalliativecare.com, n.d.)

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Explain why the nurse’s involvement in the selected issue is important.

nurses spend time with the patients

nurses build a rapport of trust

education

nurses recognize patient response

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Patient advocate

Bioethics

Evidence based practice