The crucial role of nurses and social workers in initiating end-of-life communication to reduce overtreatment in the midst of the COVID-19 pandemic

The large scale and rapid spread of the current COVID-19 pandemic has changed the way hospitals and other health services operate. Opportunity for patient-centred decision-making at end of life is being jeopardised by scarcity of health system resources. In response, the traditional doctor-initiated advance care planning (ACP) for critical illness may also need to be readjusted. We propose nurse-led and allied health-led ACP discussions to ensure patient and family inclusion and understanding of the disease prognosis, prevention of overtreatment, and potential outcomes in crisis times. We highlight known barriers and list enablers and short-term opportunities to assist in the culture change.