By Hildy M. Schell, RN, MS, CCRN, Clinical Nurse Specialist, Adult Critical Care, Department of Nursing, University of California at San Francisco Medical Center, Assistant Clinical Professor, Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California; and Kathleen A. Puntillo, RN, DNSc, FAAN, Associate Professor of Nursing, Director, Critical Care/Trauma Graduate Program, Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California |