title: Resuscitation in general medical wards: who decides?
abstract: OBJECTIVE
  To investigate nurse experiences and attitudes regarding resuscitation while focusing on intentional avoidance of action during a futile cardiac arrest.
  
  
  BACKGROUND
  Nurses often lack the legal and clinical authority to make resuscitation decisions; however, in cases where they believe that resuscitation would be futile, they may elect to delay/avoid the initiation of resuscitation as a non-confrontational method of achieving the desired endpoint, thus essentially transferring the final resuscitation decision from the physician to the nurse.
  
  
  METHODS
  An anonymous questionnaire survey conducted among a convenience sample of 122/142 nurses from five medical wards in two Jerusalem hospitals.
  
  
  RESULTS
  Nearly one-fifth (19/117) of participants reported non-initiation of a futile resuscitation. Nurses who chose not to initiate futile resuscitations were those who scored higher on the Support Do Not Attempt Resuscitation Questionnaire, those that had previously been consulted by a doctor regarding the initiation of resuscitation and those that expressed a desire to be a part of a multidisciplinary team focused on resuscitation decision-making. No other variables seemed to affect this outcome.
  
  
  CONCLUSIONS
  Nurses are often excluded from the resuscitation decision-making process despite their desire to participate. Delayed initiation/avoidance of resuscitation is being actively practiced by some nurses.
  
  
  CONCLUSIONS
  Nurses should be given the opportunity to become an essential component of resuscitation decision-making to avoid the pre-emption of medical resuscitation decisions.
authors.affiliation: Hadassah-Hebrew University, School of Nursing, Jerusalem, Israel.
authors.forename: Freda DeKeyser
authors.initials: FD
authors.lastname: Ganz
authors.forename: Nechama
authors.initials: N
authors.lastname: Kaufman
authors.forename: Sima
authors.initials: S
authors.lastname: Israel
authors.forename: Sharon
authors.initials: S
authors.lastname: Einav
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003657:Decision Making; D005260:Female; D006757:Hospital Units; D006801:Humans; D007557:Israel; D008297:Male; D012151:Resuscitation; D011795:Surveys and Questionnaires