Expert nursing care has the potential to greatly reduce the burden and distress of those at lifes end and the ability to offer support for the many physical, psychological, social, and spiritual needs of patients and their families. This protocol sets forth the evidence-based guidelines for providing appropriate end-of-life care; including symptom management; family issues and intervention; withholding and withdrawing life support; communication and conflict resolution; and caring for the caregiver. Critical care nurses spend more time with patients and families facing the end of life than any other health care professional. Nurses are intimately involved in all aspects of end-of-life care and they are in position to address the variety of needs facing individuals at this juncture. Expert nursing care has the potential to greatly reduce the burden and distress of those at life's end and the ability to offer support for the many physical, psychological, social, and spiritual needs of patients and their families.