What is needed to assist patients with advance directives from the perspective of emergency nurses

Introduction: Nurses, by the nature of their practice, are in a unique position to help patients complete advance directives (ADs). This article focuses on an open-ended question that was part of a larger quantitative survey, "What do emergency nurses need to increase their ability to assist patients with ADs?" Methods: A random sample of emergency nurses in four states was surveyed. Of the 663 nurses who responded to the survey, 506 (76%) wrote responses to the open-ended question. Thematic analysis was used to establish and saturate themes. Results: The major themes discussed most often by the nurses were the need for more education and more time to discuss ADs with patients. Other themes discussed by nurses were the need for: a supportive work environment, other health care professionals' participation conducive to assisting patients, patient/public education related to ADs, communication, and particular nursing characteristics needed to successfully assist patients with ADs. Not all the nurses in the study felt that assisting patients with ADs was the role of emergency nurses. Conclusions: Those nurses who saw assisting patients with ADs as their role were very clear about what they needed to be able to carry out the role (more time to spend with patients and more education related to ADs) and that they could not fulfill that role without the support of their institution's administration.