Enhancement of nurse-physician collaboration and nurses' participation in end-of-life decisions seems to be a managerial task that could lead to the alleviation of nurses' moral distress and their retention in the profession.

ImportanceDuring the SARS-CoV-2 pandemic, a complete physical isolation has been worldwide introduced. The impossibility of visiting their loved ones during the hospital stay causes additional distress for families: in addition to the worries about clinical recovery, they may feel exclusion and powerlessness, anxiety, depression, mistrust in the care team and post-traumatic stress disorder. The impossibility of conducting the daily meetings with families poses a challenge for healthcare professionals.ObjectiveThis paper aims to delineate and share consensus statements in order to enable healthcare team to provide by telephone or video calls an optimal level of communication with patient’s relatives under circumstances of complete isolation.Evidence reviewPubMed, Cochrane Database of Systematic Reviews, Database of Abstracts and Reviews of Effectiveness and the AHCPR Clinical Guidelines and Evidence Reports were explored from 1999 to 2019. Exclusion criteria were: poor or absent relevance regarding the aim of the consensus statements, studies prior to 1999, non-English language. Since the present pandemic context is completely new, unexpected and unexplored, there are not randomised controlled trials regarding clinical communication in a setting of complete isolation. Thus, a multiprofessional taskforce of physicians, nurses, psychologists and legal experts, together with some family members and former intensive care unit patients was established by four Italian national scientific societies. Using an e-Delphi methodology, general and specific questions were posed, relevant topics were argumented, until arriving to delineate position statements and practical checklist, which were set and evaluated through an evidence-based consensus procedure.FindingsTen statements and two practical checklists for phone or video calls were drafted and evaluated; they are related to who, when, why and how family members must be given clinical information under circumstances of complete isolation.Conclusions and relevanceThe statements and the checklists offer a structured methodology in order to ensure a good-quality communication between healthcare team and family members even in isolation, confirming that time dedicated to communication has to be intended as a time of care.

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Critical care nurses have been working for a long time to move the organisation of nursing care away from that based on the typical clinical areas of anaesthesia, resuscitation and intensive care. Their role is more appropriately oriented to the 'care of the person in a critical condition' regardless of the place in which he or she is being cared for. The critically ill patient may be a person of any age group who is in an unstable or critical condition: consequently the health/illness concept in this case assumes a natural emphasis on the illness of the cared-for person.Critical care area nurses work in a complex environment: they have to act quickly and often without the information necessary to be able to make decisions for care congruent with need. In fact the intervention is often so rapid that it is independent from the analysis of cause.The nursing interventions in the critical care area are determined on the basis of the model that considers the logic of the obtainable result, which activates the intervention. On the basis of the result, we look for the causes. So the attainable results, and the concepts of the obtained result are fundamental, which can improve in quality and quantity with constant and critical revision of the abilities and performances of nurses. The carrying out of procedures is based on the undertaking of responsibility consequent to actions autonomously carried out and interdependent actions with the doctor. Undertaking of responsibility is, in any case, a dynamic process strictly related to experience and developed ability and therefore to acquired capacity.The aim of this report is to define -in relation to the critical care area -the key words which are the theme of the 11th IPASVI (Italian National Federation of Colleges of Nurses, Health Visitors and Paediatric Nurses) National Congress. The definition of the chosen words is preceded by a short introduction and the word 'discipline' is articulated in its paradigmatic components.All this aims to facilitate the presentation and the analysis of the issue, even though we are aware of the strict interconnection of the chosen words and the related difficulty in separating the subtended concepts.

E' sempre più diffusa la convinzione che, nonostante l’invadenza delle notizie e delle fobie sullo stato dell’econo- mia, non sia direttamente il denaro, reale oppure fittizio come nei giochi di alta finan- za, a fare la differenza nella qualità di vita che possiamo costruirci.