Opening a dialogue about advance directives at the patient’s first visit and then continuing to provide education, answer questions, and discuss the importance of executing such documents can increase the number of patients who have made decisions regarding their care.

Most people do not understand what advance directives are, the role these documents play in one’s health care, or the importance of having one’s desires and requests in writing. Rhonda White, FNP, Alachua, Fla. (192-4)



These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.


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