Consent to Participate

My name is Susan Rackley. I am a critical care nurse working on my masters degree in nursing education at Southern Nazarene University. The title of my research study is “Critical Care Nurses Perception of Comfort in Discussing End of Life Issues with Families”. The research instrument being utilized is the “Caregiver Communication with Patients about Illness and Death Scale (CCID)”. The purpose of this study is to determine critical care nurses perception of comfort in discussing end of life issues with families. A demographic questionnaire accompanies the CCID and includes: birth range, gender, years of critical care experience, and highest level of nursing education achieved. Completing and submitting the CCID and demographic questionnaire is considered consent to participate in the research study.
Please review the following before completing the CCID and demographic questionnaire:
 The CCID and demographic questionnaire will take approximately ten minutes to complete.
 All responses are confidential.
 No personal identifiers are requested.
 The researcher will have no contact with the subjects.
 Any data obtained will be used for this research study only.
 If any item or statement makes you feel uncomfortable, you may skip the item or statement or withdraw from the study without penalty.
 Subjects may withdraw from the research study at any time without penalty.
 All data will be reported as aggregate (combined) not individual.
 The benefits of this research study will be to provide knowledge and insight for the improvement of end of life communication between critical care nurses and families for the nursing profession, nursing education and nursing leadership for all nurses.
If you have any questions or concerns I can be reached at or you may contact SNU IRB, 6729 N.W. 39th Expressway, Bethany, OK 73008: (405) 491-6360.
Thank you for your time and participation in this research.

Susan Rackley RN, BSN, CCRN