END-OF-LIFE DECISIONS2End-of-Life DecisionsThe nurse plays a key role in end-of-life decision making, assisting patients and their families throughout the process. Nurses spend most of their shifts with patients and their loved ones, forming caring and trusting relationships. Because of the bond nurses develop with their patients it provides them with the insight and awareness to recognize and acknowledge when patients are not responding well to treatment. The ability to assess patient and family needs places nurses in a position to assist with end-of-life decision making. Nurses are often tasked with the role of mediator, facilitating communication between patient, families, and the health care team (Adams, Bailey, Anderson, & Docherty, 2011). The nurse not only provides direct patient care but also acts as an educator, teaching patients and families about disease process, equipment, explaining terminology, and recommending treatments. In addition, nurses advocate for patients and their families while coordinating care, arranging family meetings, and relaying important information to the health care team. Helping patients and their families with end-of-life health care decisions includes many aspects of care: disease management, pain control, culturally appropriate practices, and ethical decision making (Hebert, Moore, & Rooney, 2011). Advocating for patients and families is an integral part of nursing, open and honest communication is the key to building a strong nurse-patient relationship.