title: Skills, expertise and role of Australian emergency clinicians in caring for people with advanced cancer.
abstract: OBJECTIVE
  To explore the views of Australian emergency department (ED) clinicians about their skills, role and expertise in caring for people with advanced cancer.
  
  
  METHODS
  A cross-sectional electronic survey of doctors and nurses working in Australian EDs was undertaken. Comparisons were made by demographics and whether respondents had received palliative care education.
  
  
  RESULTS
  The sample comprised 444 doctors (response rate 13.5%), the majority Fellows (emergency medicine specialists) of the Australasian College for Emergency Medicine, and 237 nurses, from all states, territories and regions (metropolitan and regional). A minority (n=123, 20.6%) felt that the ED was not an appropriate place for patients with advanced cancer to present for acute care, while almost two-thirds (n=397, 64.8%) found caring for such patients rewarding, particularly nurses and those who had received palliative care education; very few (n=40, 6.5%) reported feeling uncomfortable talking to the families of dying patients. A minority (n=129, 21.0%) felt that it was not appropriate for junior medical staff to assess these patients, nurses much more than doctors (42.9% vs 8.5%, p<0.001). Over half (n=338, 55.1%) felt sufficiently skilled in managing pain for people with advanced cancer, with Fellows, more experienced doctors, and those who had received palliative care education more likely to feel skilled.
  
  
  CONCLUSIONS
  ED clinicians in Australia, particularly those who have received palliative care education, feel comfortable and adequately skilled in managing people with advanced cancer presenting to EDs, and most find it rewarding. The importance of palliative care education to emergency clinicians' training should be recognised.
authors.affiliation: Emergency Practice Innovation Centre (EPIcentre), St Vincent's Hospital Melbourne, Australia.|Department of Medicine, The University of Melbourne (St Vincent's Hospital), Australia.
authors.forename: G A
authors.identifier: http://orcid.org/0000-0001-6157-0910
authors.initials: GA
authors.lastname: Jelinek
authors.affiliation: Emergency Practice Innovation Centre (EPIcentre), St Vincent's Hospital Melbourne, Australia.|Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: C H
authors.initials: CH
authors.lastname: Marck
authors.affiliation: Department of Palliative Care, St Vincent's Hospital Melbourne, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Weil
authors.affiliation: Centre for Palliative Care, The University of Melbourne (St Vincent's Hospital), Australia.
authors.forename: H
authors.initials: H
authors.lastname: Lane
authors.affiliation: Department of Palliative Care, St Vincent's Hospital Melbourne, Australia.|Centre for Palliative Care, The University of Melbourne (St Vincent's Hospital), Australia.
authors.forename: J
authors.initials: J
authors.lastname: Philip
authors.affiliation: Department of Palliative Care, St Vincent's Hospital Melbourne, Australia.|Centre for Palliative Care, The University of Melbourne (St Vincent's Hospital), Australia.
authors.forename: M
authors.initials: M
authors.lastname: Boughey
authors.affiliation: Emergency Practice Innovation Centre (EPIcentre), St Vincent's Hospital Melbourne, Australia.|Department of Medicine, The University of Melbourne (St Vincent's Hospital), Australia.
authors.forename: T J
authors.initials: TJ
authors.lastname: Weiland
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D009741:Nursing Staff, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D010166:Palliative Care / Q000592:standards* / Q000706:statistics & numerical data
keywords: Emergency Medicine; emergency treatment; palliative care; professional role