title: Care of the dying cancer patient in the emergency department: findings from a National survey of Australian emergency department clinicians.
abstract: BACKGROUND
  Patients with cancer are presenting to emergency departments (ED) for end-of-life care with increasing frequency. Little is known about this experience for patients and ED clinicians in Australia.
  
  
  OBJECTIVE
  To assess the barriers and enablers regarding end-of-life care for cancer patients as perceived by Australian ED clinicians.
  
  
  METHODS
  There were 4501 Australian ED clinicians invited through their professional colleges to complete an online survey, using multiple-choice and free-text responses.
  
  
  RESULTS
  A total of 681 ED clinicians responded, most (84.2%) felt comfortable providing care to the dying and found it to be rewarding (70.9%). Although 83.8% found caring for the dying a reasonable demand on their role as clinician, 83.8% also agreed that the ED is not the right place to die. Respondents demonstrated a wide range of views regarding caring for this patient group in ED through free-text responses. In addition, 64.5% reported that futile treatment is frequently provided in the ED; the main reasons reported were that limitations of care were not clearly documented, or discussed with the patient or their family. Almost all (94.6%) agreed that advance care plans assist in caring for dying patients in the ED.
  
  
  CONCLUSIONS
  Our findings provide important new insights into a growing area of care for ED. Barriers and enablers to optimal care of the dying patient in ED were identified, and especially the reported high occurrence of futile care, likely a result of these barriers, is detrimental to both optimal patient care and allocation of valuable healthcare resources.
authors: Emergency Practice Innovation Centre (EPIcentre), St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
authors: C H
authors: CH
authors: Marck
authors: J
authors: J
authors: Weil
authors: H
authors: H
authors: Lane
authors: T J
authors: TJ
authors: Weiland
authors: J
authors: J
authors: Philip
authors: M
authors: M
authors: Boughey
authors: G A
authors: GA
authors: Jelinek
mesh_terms: D001291:Attitude of Health Personnel; D001293:Attitude to Death; D001315:Australia; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000458:organization & administration*; D008875:Middle Aged; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000379:methods*
keywords: emergency medicine; medical futility; neoplasm; palliative care; terminal care