Treating each family individually to explore the family's beliefs and values on this issue is essential in healthcare practice and nurses should tailor their own approach to individual needs regarding truth-telling in different situations. Moreover, the Chinese Code of Ethics should be modified to be more specific and applicable. Finally, a narrative ethics approach should be applied and teamwork between nurses, physicians and families should be established to support cancer patients and to ensure their autonomy and hope. Ethical considerations: This paper was approved by the Ethics Committee of The Second Affiliated Hospital of Guangzhou Medical University. The authors have obtained consent to use the case study and it has been anonymised to preserve the patient's confidentiality.

Background The number of countries where nurses are legally permitted to prescribe has grown rapidly due to a variety of external and internal forces. Despite its international popularity, nurse prescribing has not yet been implemented in China widely. Objective The intent of this paper is to review the current international literature regarding nurse prescribing so as to explore the necessity and possibility of implementation of nurse prescribing in China and classify the research gap. Methods Eight electronic databases including Embase, SpringerLink, EBSCO, CINAHL, Medline, Wiley, Science Direct, CochraneLibrary were electronically searched to identify related peer-review articles published in the English language only from 2007 to 2017. Relative references found from the identified studies were traced back to ensure that potentially eligible articles were included. Results Thirty-three publications which met the inclusion criteria were included in this literature review. The literature shows that not only could nurse prescribing provide quicker service, improvements in quality, but also could make better utilization of the nurses' professional skills and increase nurses' autonomy. Moreover, the barriers of nurse prescribing are explored to identify the factors that may facilitate the success of its implementation. Conclusion The review advises that nurses' views towards nurse prescribing have played a significant role in the success of nurse prescribing. While no literature regarding Chinese nurses' attitudes towards nurse prescribing could be identified, it is imperative to examine their attitudes on it. This would help Chinese healthcare policymakers ascertain the necessity of the introduction of nurse prescribing and provide them with valuable information for service planning.

Prescriptive authority has been strictly in control within the realm of the medical profession for a long time (Fisher, 2010). However, prescriptive authority has become a reality amongst certain nurses in dozens of countries in response to growing demands for health care (Creedon et al., 2015;Delamaire & Lafortune, 2010). Nurse prescription has experienced a long process of development and was implemented at different times in different countries. It initially developed slowly, and was first introduced in the state of Idaho, America in 1969 (Fletcher et al., 2011). Since this first introduction, it has rapidly evolved globally over the past two decades.Literature has shown that not only could nurse prescription provide quicker service, improvements in quality, efficient patient care and continuity of care for patients (Courtenay et al., 2011;Tinelli et al., 2013) but also could make better utilization of the nurses' professional skills and knowledge (Phillips & Wilkinson, 2015) and increase nurses' autonomy and job satisfaction (Carey et al., 2009). Despite these, nurse prescribing has not yet been introduced widely in China.

Background A spontaneous breathing trial (SBT) is recommended to help patients to liberate themselves from mechanical ventilation as soon as possible in the ICU. The respiratory workload in SBT, which depends on being with or without respiratory support and a specific time, is more accurate to reflect how much support the weaning patients need compared with only considering SBT technologies. Aim To compare and rank the effectiveness of different respiratory workloads during SBT via differing technologies (Pressure Support Ventilation and T‐piece) and differing duration (30 and 120 min) in SBTs. Study design A comprehensive literature search was performed in six English electronic databases to identify eligible randomized controlled trials (RCTs) published before September 2020. The pooled risk ratio (RR) with 95% confidence interval (CI) was calculated by Markov chain Monte Carlo methods. A Bayesian network meta‐analysis was conducted using “gemtc” version 0.8.2 of R software. Each intervention's ranking possibilities were calculated using the surface under the cumulative ranking analysis (SUCRA). Results A total of nine RCTs including 3115 participants were eligible for this network meta‐analysis involving four different commonly used SBT strategies and four outcomes. The only statistically significant difference was between Pressure Support Ventilation (PSV) 30 min and T‐piece 120 min in the outcome of the rate of success in SBTs (RR = 0.91; 95% CI, 0.84–0.98). The cumulative rank probability showed that the rate of success in SBT from best to worst was PSV 30 min, PSV 120 min, T‐piece 30 min and T‐piece 120 min. PSV 30 min and PSV 120 min are more likely to have a higher rate of extubation (SUCRA values of 82.5% for 30 min PSV, 70.7% for 120 min PSV, 36.4% for T‐piece 30 min, 10.4% for T‐piece 120). Meanwhile, T‐piece 120 min (SUCRA, 62.9%) and PSV 120 min (SUCRA, 60.9%) may result in lower reintubation rates, followed by T‐piece 30 min (SUCRA, 41.8%) and PSV 30 min (SUCRA, 34.4%). Conclusions and relevance to clinical practice In comprehensive consideration of four outcomes, regarding SBT strategies, 30‐min PSV was superior in simple‐to‐wean patients. Besides, 120‐min T‐piece and 120‐min PSV are more likely to achieve a lower reintubation rate. Thus, the impact of duration is more significant among patients who have a high risk of reintubation. It is still unclear whether the SBTs affect the outcome of mortality; further studies may need to explore the underlying mechanism.

Objective Reflection is viewed as the most significant skill and should be advocated for lifelong learning. In order to grasp the process of reflection and embrace the reflective skill, one of the authors of this paper reflects on a practice-based issue in relation to the communication between doctors and nurses, to gain new understanding and thus improve the authors’ clinical practice. Methods Smyth’s framework with four stages is utilized as an ideal framework to guide the author’s reflection on the practice-based issue to free the author from her entrenched assumptions and the oppressive forces that limit her practice. Results The espoused and enacted theory, together with the critical reflection theory, are used to explore the values and beliefs that essentially govern the author’s practice and how these are distinct from the author’s worldviews. Following this, critical emancipatory reflection is undertaken to explore the dominant power structures within the author’s workplace. Furthermore, given the hegemonic and chaotic working context of this issue, hegemony and symbolic interaction theory are applied to unearth the various hidden constraining and oppressive forces. Additionally, socialization theory is utilized to help the author achieve professional identity. Conclusions Reconstructing the practice-based issue empowers the author to realize that in the future, she should act as a reflective practitioner, creating a daily habit, staying alert to practice, seeing things freshly, finding support systems, improving communication skills, conducting reflective research, and reifying reflective practice. Ultimately, the author will be sufficiently equipped to be able to transform her practice and change its outcomes.