1. “I think it is always an on going scenario or process because you are constantly assessing the patient and the family and communicating with the team so and that is from the very beginning really” [3.3:1.7:7] “If the patient expresses a wish to go into a hospice then we call in all of the outside social services and the palliative care team” [9.9:5.128:128] “the consultant told the family what we intended to do but said he would leave it to them to indicate when they were ready for us to start turning the adrenaline down the medications down and things like that so it was down to me to do it but kind of on the say so from the family” [8.1:5.45:45] “I would say if you [the family] are happy to have a word with our medical team then I can set a special time for us all to have a word. You [the nurse] prepare them [the family]” [7.7:4.30.30] Findings – Across all critical care areas there were similarities in what nurses aimed to achieve for patients and families in EoL care. A consistent driver in delivering EoL care was to achieve ‘a good death’ that was conceptualised as: Freedom from pain and distress Respect for patient and family Privacy and dignity Within critical care settings, certain technologies e.g. syringe drivers, were seen to facilitate ‘a good death’. Other technologies e.g, ventilators, monitors perceived to be linked to active treatment/ cure and were withdrawn in a phased way during EoL care. Personal philosophies and experiences held by critical care nurses were a potent influence that shaped the nursing role and priorities in EoL care. There were core role characteristics that all nurses demonstrated when providing and facilitating EoL care. See model. Conclusions – This study highlights the complex role that the critical care nurse plays in EoL care. The emerging model offers a framework that more clearly articulates what nurses do in EoL care, and provide a structure that could underpin preparation and support nurses as fulfil this and pivotal role. The experiences of Critical Care nurses when providing and facilitating end of life patient and family care: a cross speciality exploration Background - Public perception holds that Critical Care is delivered in a highly technical environment with a curative focus. However, overall mortality remains at 20.3%, with 70–90% of patients receiving treatment withdrawal/withholding of life support [Frick et al 2003]. Whilst end of life (EoL) care has significant health and economic impact, there is poor understanding of what EoL care challenges are held across critical care settings. Aims - This study explores experiences of critical care nurses from four clinical specialities [neurological, renal, cardiac and general Intensive Care] when involved in providing and facilitating end of life (EoL) patient and family care. Methods – This qualitative study commenced in November 2008. Interviews are based on responses to end-of-life vignettes that facilitate exploration of planning and delivery of EoL care. A stratified [by speciality], purposive sample of 16 nurses regularly involved in EoL care, are participants in the study. A modified grounded theory method is guiding data analysis. Study completion date is August 2009. M. Coombs, R. Palmer – Southampton General Hospital and University of Southampton H. Willis, D.Ugboma – Queen Alexandra Hospital, Portsmouth T Long-Sutehall, J. Addington-Hall - University of Southampton Co-ordinate: Multiple teams Facilitate: Communication Assess: Dying process Operationalise: Withdrawal processes