British Nurses Report on Advanced Care Planning (ACP)

The entire article, below, on a new survey done in Britain of nurses regarding advanced care planning:

Advance care planning (ACP) is a process of discussion about goals of care and a means of setting on record preferences for care of patients who may lose capacity or communication ability in the future. Implementation of ACP is widely promoted by policy makers.

This study examined how community palliative care nurses in England understand ACP and their roles within ACP. It sought to identify factors surrounding community nurses'implementation of ACP and nurses'educational needs.

Methods: An action research strategy was employed.

23 community nurses from two cancer networks in England were recruited to 6 focus group discussions and three follow up workshops. Data were analysed using a constant comparison approach.FindingsNurses understood ACP to be an important part of practice and to have the potential to be a celebration of good nursing care.

Nurses saw their roles in ACP as engaging with patients to elicit care preferences, facilitate family communication and enable a shift of care focus towards palliative care. They perceived challenges to ACP including: timing, how to effect team working in ACP, the policy focus on instructional directives which related poorly to patients'concerns; managing differences in patients'and families'views.

Perceived barriers included: lack of resources to; lack of public awareness about ACP; difficulties in talking about death. Nurses recommended the following to be included in education programmes: design of realistic scenarios; design of a flow chart; practical advice about communication and documentation; insights into the need for clinical supervision for ACP practice.

Conclusions: Nurses working in the community are centrally involved with patients with palliative care needs who may wish to set on record their views about future care and treatment.

This study reveals some important areas for practice and educational development to enhance nurses'use and understanding of ACP.

Author: Jane SeymourKathryn AlmackSheila Kennedy
Credits/Source: BMC Palliative Care 2010, 9:4

UK Nurses Drop Opposition to Aid in Dying.

Britain's as embroiled in a fight for aid in dying as Canada and the US. News comes now that after a poll showing public support for the choice of aid in dying, the largest nurses association in Britain has changed its stance. From Political Blog:

Britain’s main nurses’ organization has dropped its opposition to assisted suicide, as a new poll released Saturday showed solid support for the right to die.

Doctors group the British Medical Association remains opposed.

The Royal College of Nursing said it was adopting a neutral stance on the issue after its research showed nurses were divided.

A survey by Populus published Saturday found 74 percent of people wanted the medical profession to be able to supervise assisted suicides, although a large majority 85 percent felt it should be legal only in specific circumstances.

Under British law, assisting a suicide is punishable by up to 14 years in prison, but prosecutions are rare. More than 100 Britons have died in Swiss clinics run by the group Dignitas in the past decade, and none of their friends or relatives has been charged with a crime.

The issue of assisted suicide was back in the headlines this month after 85-year-old British composer Edward Downes and his wife Joan, 74, died at a Swiss suicide clinic. He was blind and increasingly deaf, while she had been diagnosed with terminal cancer.

The pollster interviewed 1,504 adults by telephone between July 17 and July 19. The margin of error is about plus or minus 2.5 percentage points.