Applied nursing research : ANR
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The purpose of this study was to determine emergency nurses' knowledge of, attitudes toward, and experiences with advance directives (ADs). This was a descriptive, correlation, mailed survey study sent to a random sample of members of the Emergency Nurses Association. The results, based on the responses of 579 emergency nurses, found that the nurses were not very knowledgeable about ADs in general (68% correct) and even less knowledgeable about the Patient Self-Determination Act (PSDA) (51% correct) and their state laws (56% correct). ⋯ Forty-seven percent of the nurses agreed that actively assisting some terminally ill patients to die should be made legal. Nurses need information pertaining to ADs in general, the PSDA, and their individual state laws. This could increase their level of confidence in being able to effectively assist patients to understand and complete ADs.
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Twenty-four percent of Americans die in nursing homes, and 80% to 95% of nursing home care is delivered by certified nursing assistants (CNAs). Interview data were collected from 27 CNAs at three facilities. Data were coded and analyzed for recurrent themes using the concepts of empathy and role taking. ⋯ Compassionate detachment, a hallmark of empathy, was evident in effective care, but problems with the ability to detach were also revealed. Organizational factors that supported empathy and those that undermined empathy were also examined. Recommendations for improving care are discussed in this article.