Dissemination of the Five Wishes Advance Directive at Work

Advance directives are invaluable resources during life-threatening situations, yet are often not even completed by nurses. Having a personal advance directive may make it easier for nurses to begin the delicate work of talking about end-of-life care decisions with patients. The purpose of this study was to determine if offering the Five Wishes advance directive to RNs will affect personal advance directive completion and ultimately impact patient advance directive completion. Preintervention data showed that 84% of nurses did not have an advance directive. Reasons stated included too young and too healthy to need it now. Postintervention, 58% totally and 28% partially completed the Five Wishes advance directive; 14% did not complete it at all. The most difficult aspect of completing an advance directive was “what kind of medical care I want and I don’t want.” RNs believed the experience of completing an advance directive would be useful in their clinical practice (mean, 4.32 [SD, 0.75]). Ninety-nine percent of participants would recommend the use of the Five Wishes. The intervention had no impact on patient advance directive completion. While Five Wishes education to nurses may increase their knowledge and attitudes about advance directive, advance directive completion by nurses is thought to be difficult and time-consuming.