As a RN you can promote and support the end of life decision process. You need to make sure that the patient and their family understands the end of life decisions that are available for the by asking open-ended questions (Hinkle & Cheever, 2014, p. 383). By asking this type of questions can allow you are the RN to asses what they understanding and where further appropriate information is needed. Also you need to establish a therapeutic relationship with the patient and become and patient advocate. Establishing a therapeutic relationship with the patient may allow that patient to open up about and concerns or questions that they may have. Being a patient advocate means that you will defend and support the patient's autonomous decisions even if you do not agree (Treas & Wilkinson, 2014, p. 1543).
There are many things that can impact having end of life conversations with patients and families and the nurse's personal beliefs and feelings are one of them. When a nurse is unable to set aside own beliefs and feelings of disagreement toward a patient's decisions, the nurse may be judgmental and have a negative attitude (Hinkle & Cheever, 2014). These actions can cause a communication barrier making it difficult for the end of life conversation to happen. Judging the patient based upon their religious or cultural beliefs may cause them to question between what is right and wrong for end of life care.