Speaking for the Patient:  What Advance Care Directives Mean for Nurses

When patients arrive in crisis, split-second decisions matter — but what happens when an Advance Care Directive is in place? This session explores the real experiences of Australian emergency nurses and doctors using ACDs in practice. We’ll unpack the benefits, the barriers, and the crucial role nurses play in communicating with families, clarifying goals of care, and ensuring treatment aligns with a patient’s wishes. This session aims to strengthen your confidence in navigating end-of-life care conversations where it matters most.
CPD HOURS: 1
 Registration Year 2025/2026

Course Content

Today, we’re going to look at an article by Omoya and colleagues (2023) that explores how emergency doctors and nurses in Australia use advance care directives in the emergency department. I’ve summarised the key points for you — this is my interpretation of the article, not a direct copy of the text.

The research found that advance care directives can be really useful, especially in starting conversations about end-of-life care, but they’re not always available or up to date. Nurses in particular play an important role in helping families and patients make sense of these documents, and in ensuring that care aligns with the person’s wishes. So what I’ll do today is walk you through the main findings and show you why this is so relevant to our everyday practice in emergency care.

This article explored how Australian emergency doctors and nurses experience the use of advance care directives (ACDs) in the emergency department (ED), particularly in end-of-life care.

Why this Session may be Relevant to your Work

This knowledge is relevant to nursing practice because it supports informed, patient-centred end-of-life care by ensuring treatment decisions in the emergency department reflect patients’ documented wishes, clinical realities, and effective communication with families.

Learning Outcomes mapped to NMBA Standards

Outcome 1

Explain the role and limitations of advance care directives (ACDs) in the emergency department and their impact on end-of-life decision making.
  • NMBA Standard 1.1, 1.2, 1.5: Thinks critically and analyses practice; uses evidence to inform safe practice; and applies ethical frameworks in decision-making.
  • NMBA Standard 2.1: Engages in therapeutic and professional relationships that respect patients’ rights to participate in care decisions.

Outcome Two

Recognise barriers to effective use of ACDs, including limited knowledge among patients and families, communication challenges, and lack of availability of documentation.
  • NMBA Standard 1.5: Integrates evidence and policy into practice to support informed decision making.
  • NMBA Standard 2.2, 2.3: Communicates effectively; provides information to support patient understanding.
  • NMBA Standard 3.7: Documents assessments and care in a timely, accurate, and comprehensive manner.

Outcome Three

Differentiate between advance care directives and goals of patient care (GOPC), and describe how they can be used together to guide treatment decisions in emergencies.
  • NMBA Standard 1.1, 1.3: Applies critical thinking and nursing knowledge to practice; maintains accountability for decisions.
  • NMBA Standard 6.5: Understands and responds to the dynamic nature of care, adapting to patient needs and available evidence.

Outcome Four

Discuss the importance of clear, collaborative communication between clinicians, patients, and families in ensuring that end-of-life care aligns with the patient’s values and preferences.
  • NMBA Standard 2.2: Practices in a way that supports open, honest, and respectful communication.
  • NMBA Standard 3.3: Engages in collaborative practice, delegating and consulting as appropriate.
  • NMBA Standard 2.5: Advocates on behalf of people in a manner that respects the person’s autonomy and dignity.
Today, we will examine an article by Omoya and colleagues (2023) that investigates how emergency doctors and nurses in Australia utilise advance care directives in the emergency department. I’ve summarised the key points for you — this is my interpretation of the article, not a direct copy of the text.

The research found that advance care directives can be really useful, especially in starting conversations about end-of-life care, but they’re not always available or up to date. Nurses in particular play an important role in helping families and patients make sense of these documents, and in ensuring that care aligns with the person’s wishes. So what I’ll do today is walk you through the main findings and show you why this is so relevant to our everyday practice in emergency care.
This article explored how Australian emergency doctors and nurses experience the use of advance care directives (ACDs) in the emergency department (ED), particularly in end-of-life care.

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Sue Walker

RN, BN, BN (ADMIN), MPHC, MACN
Sue is the director and co-founder of the Nurses for Nurses Network. Sue is a key contributor to the online education platform Nursing CPD – a Continuing Professional Development platform to assist Nurses in meeting their annual CPD requirements.
As a Registered Nurse, Sue holds Degrees in both Nursing and Health Administration, a Master’s Degree in Public Health, and more...