‘Trust me, I’m a nurse’

A sound understanding of moral and legal obligations is critical to developing responsible nursing practice and building the nurse-patient relationship. Ethics and Law for Australian Nurses provides a practical framework for understanding the ethical and legal dimensions of nursing practice. The fourth edition has been thoroughly revised to include updates to legislation, the NMBA professional standards and case examples. A new chapter on the legal system and a fully revised chapter on duty of care and negligence provide a thorough overview of the law as it applies to nursing practice. The text also includes expanded material on the regulation of nursing practice, advanced care directives, cultural safety, practice in the context of digital environments, person-centred care and assisted dying. Written in an accessible and engaging style, Ethics and Law for Australian Nurses provides a comprehensive guide for nurses training and practising in clinical, research and policy settings.

A sound understanding of moral and legal obligations is critical to developing responsible nursing practice and building the nurse-patient relationship. Ethics and Law for Australian Nurses provides a practical framework for understanding the ethical and legal dimensions of nursing practice. The fourth edition has been thoroughly revised to include updates to legislation, the NMBA professional standards and case examples. A new chapter on the legal system and a fully revised chapter on duty of care and negligence provide a thorough overview of the law as it applies to nursing practice. The text also includes expanded material on the regulation of nursing practice, advanced care directives, cultural safety, practice in the context of digital environments, person-centred care and assisted dying. Written in an accessible and engaging style, Ethics and Law for Australian Nurses provides a comprehensive guide for nurses training and practising in clinical, research and policy settings.

A sound understanding of moral and legal obligations is critical to developing responsible nursing practice and building the nurse-patient relationship. Ethics and Law for Australian Nurses provides a practical framework for understanding the ethical and legal dimensions of nursing practice. The fourth edition has been thoroughly revised to include updates to legislation, the NMBA professional standards and case examples. A new chapter on the legal system and a fully revised chapter on duty of care and negligence provide a thorough overview of the law as it applies to nursing practice. The text also includes expanded material on the regulation of nursing practice, advanced care directives, cultural safety, practice in the context of digital environments, person-centred care and assisted dying. Written in an accessible and engaging style, Ethics and Law for Australian Nurses provides a comprehensive guide for nurses training and practising in clinical, research and policy settings.

A sound understanding of moral and legal obligations is critical to developing responsible nursing practice and building the nurse-patient relationship. Ethics and Law for Australian Nurses provides a practical framework for understanding the ethical and legal dimensions of nursing practice. The fourth edition has been thoroughly revised to include updates to legislation, the NMBA professional standards and case examples. A new chapter on the legal system and a fully revised chapter on duty of care and negligence provide a thorough overview of the law as it applies to nursing practice. The text also includes expanded material on the regulation of nursing practice, advanced care directives, cultural safety, practice in the context of digital environments, person-centred care and assisted dying. Written in an accessible and engaging style, Ethics and Law for Australian Nurses provides a comprehensive guide for nurses training and practising in clinical, research and policy settings.

A sound understanding of moral and legal obligations is critical to developing responsible nursing practice and building the nurse-patient relationship. Ethics and Law for Australian Nurses provides a practical framework for understanding the ethical and legal dimensions of nursing practice. The fourth edition has been thoroughly revised to include updates to legislation, the NMBA professional standards and case examples. A new chapter on the legal system and a fully revised chapter on duty of care and negligence provide a thorough overview of the law as it applies to nursing practice. The text also includes expanded material on the regulation of nursing practice, advanced care directives, cultural safety, practice in the context of digital environments, person-centred care and assisted dying. Written in an accessible and engaging style, Ethics and Law for Australian Nurses provides a comprehensive guide for nurses training and practising in clinical, research and policy settings.

To discover where patients with advance directives (ADs) obtain them and to learn what patients' understanding is of how ADs function. Adult patients with ADs admitted to the four acute-care hospitals in Monterey County, California, were asked to participate in a survey during the study period 1 July to 8 September 2009. Of 5,811 total admissions, 455 patients (7 percent) had an AD. Of these 455 patients, 204 (45 percent) completed our survey. Participants included 146 patients with a power of attorney for healthcare (72 percent), and 21 patients who were unable to identify the type of AD they had (10 percent). Attorneys provided ADs to 99 participants (49 percent) and personal physicians provided ADs to 12 participants (6 percent). Most participants (181, or 89 percent) had spoken to their family about their AD; fewer (131, or 65 percent) to their physician. Of the 146 participants with a power of attorney, only 73 (50 percent) said they had spoken specifically to their agent. Family members (38 percent) and attorneys (35 percent) were seen as helpful in completing ADs; physicians (1 percent) were not. Few study participants had advance directives, and attorneys provided and discussed ADs with study participants more than physicians did. Because many patients with ADs seem not to fully understand them, new approaches to advance planning education must be developed.

The third edition of Ethics and Law for Australian Nurses develops an innovative practical framework for understanding the ethical and legal dimensions of nursing practice in Australia. Taking a 'relational' approach to practice, the text foregrounds the concepts of personhood, vulnerability and the nurse-patient relationship as the source of a nurse's moral and legal obligations. This approach is central to the book's discussion of key ethical and legal concepts throughout the text including consent and autonomy, negligence and liability, confidentiality and trust, and culturally safe practice. This edition has been thoroughly revised to include the latest research and methods, updated legislation and links to professional documentation, along with a new chapter on aged care. Student learning is supported by case studies, legal case extracts and learning exercises. A new instructor companion website features a curated suite of multimedia resources and extension questions.

Ramifications of Diminished Capacity

SUN-094 A single centre review of end-of-life discussions and location of death in a dialysis population between 2016 and 2017

Introduction: When presenting to the Emergency Department (ED), the care of elderly patients residing in Long Term Care (LTC) can be complicated by threats to patient safety created by ineffective transitions of care. Though standardized inpatient handover tools exist, there has yet to be a universal tool adopted for transfers to the ED. In this study, we surveyed relevant stakeholders and identified what information is essential in the transitions of care for this vulnerable population. Methods: We performed a descriptive, cross sectional electronic survey that was distributed to physicians and nurses in ED and LTC settings, paramedics, and patient advocates in two Canadian cities. The survey was kept open for a one month period with weekly formal reminders sent. Questions were generated after performing a literature review which sought to assess the current landscape of transitional care in this population. These were either multiple choice or free text entry questions aimed at identifying what information is essential in transitional periods. Results: A total of 191 health care providers (HCP) and 22 patient advocates (PA) responded to the survey. Within the HCPs, 38% were paramedics, 38% worked in the ED, and 24% were in LTC. In this group, only 41% of respondents were aware of existing handover protocols. Of the proposed informational items in transitional care, 100% of the respondents within both groups indicated that items including reason for transfer and advanced care directives were essential. Other areas identified as necessary were past medical history and baseline functional status. Furthermore, the majority of PAs identified that items such as primary language, bowel and bladder incontinence and spiritual beliefs should be included. Conclusion: This survey demonstrated that there is a need for an improved handover culture to be established when caring for LTC patients in the ED. Education needs to be provided surrounding existing protocols to ensure that health care providers are aware of their existence. Furthermore, we identified what information is essential to transitional care of these patients according to HCPs and PAs. These findings will be used to generate a simple, one page handover form. The next iteration of this project will pilot this handover form in an attempt to create safer transitions to the ED in this at-risk population.

Heart failure (HF) is the most common reason for hospital admission for patients older than 65 years. With an aging population and improving survival in heart failure patients, the number of people living with HF continues to grow. As this population increases, the importance of treating symptoms of fatigue, dyspnea, pain, and depression that diminish the quality of life in HF patients becomes increasingly important. Palliative care has been shown to help alleviate these symptoms and improve patients' satisfaction with the care they receive. Despite this growing body of evidence, palliative care consultation remains underutilized and is not standard practice in the management of HF. With an emphasis on communication, symptom management, and coordinated care, palliative care provides an integrated approach to support patients and families with chronic illnesses. Early communication with patients and families regarding the unpredictable nature of HF and the increased risk of sudden cardiac death enables discussions around advanced care directives, health care proxies, and deactivation of permanent pacemakers or implantable cardioverter defibrillators. Cardiologists and primary care physicians who are comfortable initiating these discussions are encouraged to do so; however, many fear destroying hope and are uncertain how to discuss end-of-life issues. Thus, in order to facilitate these discussions and establish an appropriate relationship, we recommend that patients and families be introduced to a palliative care team at the earliest appropriate time after diagnosis.

The third edition of Ethics and Law for Australian Nurses develops an innovative practical framework for understanding the ethical and legal dimensions of nursing practice in Australia. Taking a 'relational' approach to practice, the text foregrounds the concepts of personhood, vulnerability and the nurse-patient relationship as the source of a nurse's moral and legal obligations. This approach is central to the book's discussion of key ethical and legal concepts throughout the text including consent and autonomy, negligence and liability, confidentiality and trust, and culturally safe practice. This edition has been thoroughly revised to include the latest research and methods, updated legislation and links to professional documentation, along with a new chapter on aged care. Student learning is supported by case studies, legal case extracts and learning exercises. A new instructor companion website features a curated suite of multimedia resources and extension questions.

The third edition of Ethics and Law for Australian Nurses develops an innovative practical framework for understanding the ethical and legal dimensions of nursing practice in Australia. Taking a 'relational' approach to practice, the text foregrounds the concepts of personhood, vulnerability and the nurse-patient relationship as the source of a nurse's moral and legal obligations. This approach is central to the book's discussion of key ethical and legal concepts throughout the text including consent and autonomy, negligence and liability, confidentiality and trust, and culturally safe practice. This edition has been thoroughly revised to include the latest research and methods, updated legislation and links to professional documentation, along with a new chapter on aged care. Student learning is supported by case studies, legal case extracts and learning exercises. A new instructor companion website features a curated suite of multimedia resources and extension questions.

The third edition of Ethics and Law for Australian Nurses develops an innovative practical framework for understanding the ethical and legal dimensions of nursing practice in Australia. Taking a 'relational' approach to practice, the text foregrounds the concepts of personhood, vulnerability and the nurse-patient relationship as the source of a nurse's moral and legal obligations. This approach is central to the book's discussion of key ethical and legal concepts throughout the text including consent and autonomy, negligence and liability, confidentiality and trust, and culturally safe practice. This edition has been thoroughly revised to include the latest research and methods, updated legislation and links to professional documentation, along with a new chapter on aged care. Student learning is supported by case studies, legal case extracts and learning exercises. A new instructor companion website features a curated suite of multimedia resources and extension questions.

Objectives:Published research in disparities in advance care planning, palliative, and end-of-life care is limited. However, available data points to significant barriers to palliative and end-of-life care among minority adults. The main objective of this scoping review was to summarize the current published research and literature on disparities in palliative and hospice care and completion of advance care planning and directives among non-Hispanc Blacks.Methods:The scoping review method was used because currently published research in disparities in palliative and hospice cares as well as advance care planning are limited. Nine electronic databases and websites were searched to identify English-language peer-reviewed publications published within last 20 years. A total of 147 studies that addressed palliative care, hospice care, and advance care planning and included non-Hispanic Blacks were incorporated in this study. The literature review include manuscripts that discuss the intersection of social determinants of health and end-of-life care for non-Hispanic Blacks. We examined the potential role and impact of several factors, including knowledge regarding palliative and hospice care; healthcare literacy; communication with providers and family; perceived or experienced discrimination with healthcare systems; mistrust in healthcare providers; health care coverage, religious-related activities and beliefs on palliative and hospice care utilization and completion of advance directives among non-Hispanic Blacks.Discussion:Cross-sectional and longitudinal national surveys, as well as local community- and clinic-based data, unequivocally point to major disparities in palliative and hospice care in the United States. Results suggest that national and community-based, multi-faceted, multi-disciplinary, theoretical-based, resourceful, culturally-sensitive interventions are urgently needed. A number of practical investigational interventions are offered. Additionally, we identify several research questions which need to be addressed in future research.