1. Cady, Rebecca F. JD, BSN, RNC

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This issue presents a nice combination of articles addressing various aspects of end-of-life care. Marcia Bosek's group has done an interesting study regarding perceptions of a "good death" for patients with Alzheimer's disease in nursing homes. Lisa Anderson-Shaw's article deals with the practical issues that arose at one facility when it implemented a policy for "unilateral" do-not-resuscitate (DNR) orders. Lastly, this issue includes our regularly featured Ethics in Practice column, which addresses nurses' suffering in relation to patients' deaths. We all know that most of the nation's healthcare dollars are spent either at the beginning or end of the life span. In light of the continued nursing shortage it behooves those of us in managerial or administrative positions to consider what the "human costs" are for nurses who care for patients on the ends of the life span, and how these costs can be minimized.


This issue's Continuing Education article focuses on the Final Rule regarding the Department of Health and Human Service's Quality Assessment and Performance Improvement Program, which became effective on March 25, 2003.


It seems as though every week I read about another physician walkout to protest malpractice insurance rates and to demand malpractice litigation reform. Malpractice litigation and its (some say alleged) effect on physicians' malpractice rates has become a "powder keg" topic these days. How have physician walkouts affected your facility, and how have you dealt with these situations? We would be very interested to hear about your experiences.