Patients admitted to hospital with acute symptoms may become terminally ill and, should this occur, it is vital that clinicians can make decisions based on knowledge of the person’s care preferences. Natalie Pattison explores the issues

As survival rates for patients with cancer improve, more patients are accessing critical care. This article explores the background to decisions to admit to critical care, as well as outcome data for critically ill cancer patients and notions of appropriateness of treatment. Caring for critically ill cancer patients who are moving from an active to an end of life phase presents a unique challenge for nurses. The article discusses issues involved in transitions of care, such as decision making and nurses’ roles.