Dying and death in critical care settings can have particularly negative implications for the bereavement experience of family members, family interaction and the wellbeing of critical care staff. This study explored critical care staff perspectives of dying, death and bereavement in this context, and their role related to patients and their families, adopting a multidisciplinary perspective.

This study employed a descriptive exploratory qualitative design, using reflexive thematic analysis to interpret the data. Semi-structured interviews were conducted with 15 critical care staff from hospitals in the Republic of Ireland. Most participants were female (n = 11), with four male participants. Professional disciplines included nursing, dietetics, physiotherapy, anaesthesiology and medicine.

Key findings included supporting a 'nice death' for patients and their families, the challenges critical care staff experience, the need for better supports in critical care, and the need for change in current bereavement support provision given the diversity evident in the modern Irish population.

This study suggests that the unique challenges faced by staff and families throughout the dying process may benefit from the development of additional psychological, educational, and infrastructural supports. Inconsistencies in supports across critical care units in Ireland were also identified. Future research should complement the current study and examine family members' experience of the dying process in critical care and their perspectives on supports provided.

This quantitative study aimed to analyse the relationship between knowledge and nurses' self-confidence (or self-efficacy) in applying palliative care (PC) in the intensive care unit (ICU). This study was a correlational study with a cross-sectional approach. The sampling technique used was total sampling, and the sample included all nurses who were actively working at the general hospital in Bandung, West Java, Indonesia, during the study. There were 127 people in total. Data were collected using questionnaires. The Pearson correlation test was used for bivariate analysis. The results of univariate analysis showed that the majority of respondents had high self-confidence but had less knowledge related to PC in the ICU. Based on the results of the bivariate analysis, there was a significant relationship between knowledge and self-confidence variables. The results showed that a high number of respondents had less knowledge in implementing PC in the ICU. Therefore, familiarisation sessions and training related to this are needed, focusing on nurses' beliefs in their abilities.

Encapsulating peritoneal sclerosis (EPS) is a rare but devastating complication of peritoneal dialysis. It is characterized by peritoneal neovascularization, fibrosis, and calcification ultimately leading to intestinal obstruction and eventual failure. Surgery for EPS has a mortality approaching 50% and most patients require some form of postoperative life-sustaining therapy (LST) during their admission. A 43-year-old gentleman with progressive EPS and significant comorbidities was assessed for enterolysis after a failed first attempt at another center. Because of his comorbidities, postoperative mortality was quoted above 50%. The patient favored surgery to improve his survival and quality of life, but was reluctant to receive prolonged LST in the event of failure of surgical therapy. The surgical team, in conjunction with a palliative care physician, therefore held extensive discussions with the patient and his partner regarding LST and its limitations. Clinical parameters to trigger a transition to palliative care were identified and agreed. Limitations on LST that are directly expressed by patients can represent a contraindication to surgery for many surgeons. Surgical Buy-In is a concept described as a perceived contract, or covenant, between the patient and clinician regarding implied consent for postoperative LST. Currently, preoperative discussions regarding limitations of LST are infrequent, and there can be reticence among patients and surgeons to have these conversations, leading to dissatisfaction on behalf of the patient and their family. After the Montgomery legal ruling, the provision and perception of informed consent are particularly pertinent. The palliative care physician is uniquely placed to contribute to such discussions as part of the surgical multidisciplinary team.