This study aims to determine changes in emergency nurses’ care practices and conflicts with families of dying patients during the COVID‒19 pandemic and the impact of these conflicts on their mental health. We conducted a web-based survey with 1,048 emergency nurses and received 284 responses. The findings suggest that emergency nurses were conflicted that they could no longer provide care that encouraged family members to approach the patient so that they could spend their final hours with them, which increased the risk of burnout and depression. However, it is noteworthy that emergency nurses made efforts to communicate with the family members and inform them about the patient’s condition. Further, despite their conflicts, they actively practiced desirable nursing care while conforming to the COVID‒19 pandemic.

An awareness survey on “Do Not Attempt Resuscitation” (DNAR) was conducted among nurses working in long-term care wards“．Living wills”,“ wishes of families” and“ age” ranked high among factors that led nurses to think that “DNAR should be considered”. Of the “DNAR orders” given by physicians,“ mechanical ventilation” and“ electric defibrillation” were ranked high as“ procedures that should not be performed”．There were also answers that“ suction during aspiration and phlegm suction” should not be implemented, even if in a smaller number.

As for the method of giving “DNAR orders”, even when patients were capable of making decisions, “providing information to the patient and explaining the medical condition” and “confirming the patient’s intention” were less than 70%，and“ continued discussion with the patients themselves” was less than 50%.　There is a need to establish a training system and to create manuals on“ DNAR”, as well as to build cooperative relationships between medical professionals.

A 60-something man with left maxillary sinus cancer. The patient had no relatives, and his pessimistic behavior increased after his temporary discharge from the hospital.

As we listened to the patient's thoughts and feelings, he expressed his desire to“ help people in the future.” I explained pathological autopsy to him. Pathological autopsy was performed according to the will after the diagnosis of death.

In this case, we were able to respond to spiritual pain with a specific process of listening, providing information, and supporting and developing choices. Pathological autopsy has the potential to help in managing the patient's spiritual pain in each of the three dimensions of temporality, relationship, and autonomy.

Objective: To clarify the meaning of“ walking” for the terminal cancer patient in our study. Patient and Methods: A life chart was composed based on the illness narratives of the terminal cancer patient, and meanings of “walking” were examined from the patient’s descriptions on “walking.” Results: Physical conditions, beliefs, and feelings during infancy, childhood, adolescence, and adulthood were addressed, and the meaning of “walking” was clarified. The meaning varied from time to time, and could be something that gave one a“ sense of being firmly attached to the earth” and feeling“ grateful,”or it could be“an orientation toward the future,”“doing the work,” or“ a wonderful thing that people will not be happy about.” Discussion: The meaning of“ walking” was summarized as“ the will to carry out one’s own core beliefs.”

An online end-of-life care training program was completed by 23 nurses and care workers at a geriatric health services facility. This study evaluated the program’s effectiveness through assessments conducted before, immediately after, and 3 months post raining. Participants attended lectures, participated in focus group discussions, and completed questionnaires. We assessed the participants’ reactions to the training program, their end-of-life care knowledge, confidence/willingness to perform end-of-life care, difficulties with end-of-life care, and job satisfaction. Analysis of 18 valid responses revealed that the training program resulted in increased end-of-life knowledge and job satisfaction.

Participants difficulties with end-of-life care, and a lack of confidence/willingness, may be attributable to the short training period. Therefore, the program should be supplemented with more practical training content and follow-up training to address these issues. Programs need to be evaluated from multiple perspectives. To our knowledge, there is no comparative pre- and post-intervention studies using the five evaluation measures used in this study.