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Discussion 4PICO(T): Comfort based care including pain management and symptom management is key to improving and maintaining quality of life of hospice patients, whether they are actively dying or in early stages of the end of life. In patients with terminal illness on hospice/palliative care service, does education of comfort medications, compared to education at the time of transition to actively dying improve pain, symptom management, quality of life and apprehension during the end of life. The article I chose to review was “Nurses’ Perceptions of Medication Use at the End of Life in an Acute Care Setting.”The article discusses a qualitative descriptive study that included a total of 22 nurses from 8 different med/surg units. The purpose of the study was to identify nurses’ perceptions of the use of medications at the end of life. “Nurses identified 4 main variables that impacted medication use at the end of life: perceived knowledge and skill, conflicting perspectives, resource and education needs and the emotional experience (Howes, 2015).”