A nurse recently expressed concern about maintaining patient comfort during terminal weaning in an ICU. ("Terminal Weaning: Protocol for Peaceful Death," Insights on Death and Dying, February 2008).*

As a hospice consultant, I'd like to suggest having hospice service in place before weaning begins.

The hospice medical director and other members of the hospice team have expertise in managing end-of-life symptoms and can help the patient make the transition with less pain and agitation. I also suggest providing a staff-development program for nurses, physicians, and other providers to teach them what hospice can offer a patient undergoing terminal weaning.

ELIZABETH PENTIN, RN

Pittsburgh, Pa.

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