Table 3.

Nurses' Perceptions of Need for Educating Patients, Families, Nurses, and Physicians on Palliative Sedation

Patient	“Doctors, social workers, family members as well as the patients all need to be made knowledgeable and that this is truly last resort.”
Family	“Before you start palliative sedation you first must inform the family of all the levels. There needs to be education in order to see a true change in understanding.”
	“Family members, you often find, need a lot of information about what they might expect to occur with the patient. As they go [through] this process, which is normal, they require a lot of reassurance so we have to be able to certainly address what their informational needs are as well as [provide] emotional support”
	“I think we need to educate the families, because someone might hear palliative sedation and it just sounds awful to them or it might draw up flags for them.”
Nurse	“In our nurse residency program, we issued a class on death and dying, where we talk about end-of-life care and sedation. That's all that has really been covered. There are eight hours of end-of-life education.”
	“I don't think there has been any formal education as to what palliative sedation is, you kind of go along being a nurse for 10-20 years and have been exposed to situations such as this, but if you have only been a nurse for a couple of years it is hard.”
	“If the nurses don't understand it, how can we explain it to our patients?”
Physician	“There has to be education for the physicians, a formal education for everyone who goes to medical school to give them an understanding.”
	“I think the entire team should be educated on it, and be able to discuss it, talk about it, and discuss whether this would be beneficial or not to the patient.”
	“One patient was uncomfortable, thrashing around in bed and I called the doctor and said, ‘This isn't cutting it; I've medicated her every 2 hours for the past 12 hours and she's uncomfortable.’ The doctor said, ‘Well she doesn't talk and I don't know if she's in pain or not.’ The doctor would not change it. She was definitely uncomfortable, but because she wouldn't talk, he wouldn't do anything about it.”