Uses the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001) to guide practice.

Delivers care in a manner that preserves and protects patient autonomy, dignity, rights, values, and beliefs.

Recognizes the centrality of the patient and family as core members of any healthcare team.

Upholds the patient’s confidentiality within legal and regulatory parameters.

Assists patients in self-determination and informed decision-making.

Maintains a therapeutic and professional patient-nurse relationship with appropriate professional role boundaries.

Contributes to resolving ethical issues involving patients, colleagues, community groups, systems, and other stakeholders.

Takes appropriate action regarding instances of illegal, unethical, or inappropriate behavior that could endanger or jeopardize the best interests of the patient or situation.

Questions, when appropriate, healthcare practices and/or addresses issues related to safety and quality improvement.

Advocates for equitable access to care.

Articulates a working knowledge of palliative and end-of-life ethical issues.

Promotes patient care practices that originate from the ethical principles of beneficence, respect for individuals and self-determination, justice, and nonmaleficence, with attention to avoiding conflicts of interest.

Participates in interdisciplinary teams that address ethical risks, burdens, benefits, and outcomes.

Provides information on the risks, burdens, benefits, and outcomes of healthcare regimens to allow informed decision-making by the patient, including informed consent, assent, and refusal.

Initiates ethical review of clinical and healthcare issues.

Seeks counsel from an ethics committee, as appropriate.

Maintains knowledge of legal issues in palliative care, such as those related to federal and state law for resuscitation orders, informed consent, a patient’s right to decline care, use of high-dose medications, withdrawal of technology (e.g., ventilators, dialysis, antibiotics), palliative sedation, futile care, cessation of artificial and oral nutrition and hydration, and other pertinent issues.

Participates in ongoing educational activities related to appropriate knowledge base and professional topics related to palliative care.

Educates patient, families, other healthcare clinicians, and the public about hospice, palliative care, and the role of the hospice and palliative nurse.

Demonstrates a commitment to lifelong learning through self-reflection and to address learning needs and professional growth needs.

Seeks experiences that reflect current palliative nursing practice to maintain knowledge, skills, abilities, and judgment in clinical practice or role performance.

Acquires palliative knowledge and skills appropriate to her or his role, population, specialty, setting, or situation.

Seeks formal and independent learning activities to develop and maintain clinical and professional skills and knowledge in palliative nursing.

Identifies learning needs based on palliative nursing knowledge, the various roles the nurse may assume, and the changing needs of the population.

Participates in formal and informal consultations to address issues in palliative nursing practice as an application of education and knowledge base.

Shares educational findings, experiences, and ideas with peers.

Contributes to a work environment conducive to the education of healthcare professionals.

Maintains professional records that provide evidence of competence and lifelong learning in palliative nursing.

Uses current healthcare research findings and other evidence to expand clinical knowledge, skills, abilities, and judgment; to enhance role performance; and to increase knowledge of professional topics.

Utilizes current evidence-based nursing knowledge, including research findings, to guide palliative nursing practice.

Incorporates evidence when initiating changes in palliative nursing practice.

Participates, as appropriate to education level and position, in the formulation of evidence-based practice through research.

Shares personal or third-party research findings with colleagues and peers.

Contributes to nursing knowledge by conducting or synthesizing research and other evidence that discovers, examines, and evaluates current practice, knowledge, theories, criteria, and creative approaches to improve healthcare outcomes.

Promotes a climate of research and clinical inquiry.

Disseminates palliative research findings through activities such as presentations, publications, consultation, and journal clubs.

Demonstrates quality by documenting the application of the palliative nursing process in a responsible, accountable, and ethical manner.

Focuses on quality palliative nursing relating to serious or lifethreatening illness, offering the right care at the right time, in the course of a patient’s disease or condition.