Testicular tumors are potentially curable by means of high-dose chemotherapy plus hematopoietic stem-cell rescue, even when this regimen is used as third-line or later therapy or in patients with platinum-refractory disease.

Findings reveal new information about ethical dilemmas encountered by nurses and strategies for improving end-of-life communications with advanced cancer patients.

Opportunities for oncology nurses to bridge some gaps in prognosis-related communication likely exist, although barriers surrounding nurses' role, education, and communication within the context of the larger healthcare team need to be clarified if potential solutions are to be developed.

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Unit-based ethics conversations (UBECs) provide nurses with an opportunity for meaningful conversation about the ethical issues they face in routine clinical practice. The goal of the program is to increase participants' abilities and confidence in dealing with ethically challenging situations. This article reviews results from a formal evaluation of UBECs at one organization. The results of this evaluation suggest the UBEC program provides a transformational ethics experience for nurses.

The self-described wide variation and nonadherence to professional and regulatory standards within the facility-based validation process for PSIs raise concerns about the use of these data to make meaningful judgments about quality and safety. The authors recommend a standardized approach to reporting and validation be implemented for use of PSIs in public reporting and pay-for-performance programs.

6602 Background: PRC is critical to care, treatment, and decision-making for advanced cancer patients (ACP). Deficits in oncologists’ (MDs) PRC have previously been identified. The role oncology nurses (RNs) play in PRC and their views and experiences of PRC among MDs with whom they work is unknown. Methods: Mail survey of a random sample of Oncology Nursing Society members with at least one year of experience working with cancer patients (pts). Questionnaire was sent to 1338 members of ONS. 394 completed surveys were returned. Overall RR was 29.4%. Significance, if noted, implies p<0.001. Results: Respondent demographics: median age 49.2, 96.6% female, 88.5% Caucasian, median years (yrs) as an RN 18, median yrs working with cancer patients 12, 69.1% had a BSN or ASN, 34.1% inpt RNs, 38.6% outpt RNs. 46% of RNs always/often cared for ACPs who did not appear to understand their prognosis, and 58.6% of RNs always/often encountered questions that suggested pts wanted more prognosis related information (PRI). 26.1% disagreed that the MDs they worked with were skilled at PRC. 72% agreed that MD discomfort with giving bad news is a major barrier to helping pts understand their prognosis. 54.9% of RNs always/often/sometimes felt pressured not to provide pts PRI because they did not want to contradict what MDs had said. 25.1% of RNs felt that MDs rarely or never kept them informed about their PRC with pts (frequency positively associated with yrs as an RN, yrs working with cancer pts, education level). RNs with at least an MSN were more likely to report that MDs more frequently kept them informed about their PRC. 30.2% of RNs felt that MDs rarely or never addressed end of life issues early in the course of their illness. 32.8% of RNs agreed that, when pts did not appear to understand their prognosis, it was because MDs had not discussed it fully (positively associated with working in an inpt setting). 42.6% of RNs were rarely or never present when PRI was discussed (negatively associated with working in an outpt setting and amount of formal education regarding PRC). Conclusions: Oncology RNs identify several deficits in MDs’ PRC with ACPs, including provision of information early in the course of illness, gaps in sharing content of PRC with RNs, and communicative aspects of team-based pt care. No significant financial relationships to disclose.