The Department of Health’s 2008 End of Life Care Strategy, provides a comprehensive framework aimed at promoting high quality care for all adults approaching the end of life in all care settings in England. Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care. A legal requirement of end of life care is that the wishes of the individual, including whether CPR should be attempted, as well as their wishes how they are cared for after death are properly documented. This means that their rights and wishes even after death are respected.…
The family members play an important role and helping care for the patient helps them with the grieving process while providing a supportive environment to express their grief while coping with their feelings (Davidson, 2010). The second intervention would to have been to take a moment to request a chaplain or ask some one to request one for the family to talk to them about what is happening and how they are coping with this situation and if there is a need for spiritual counseling for them or the patient. This gives the family members a chance to express the desire to have any rituals performed for the patient. Also, to help them cope more effectively with the psychological and emotional stain of their family member’s illness and the dying process (Davidson, 2010). Last, the third intervention would be getting the family a list of some activities that the family members can do that will help facilitate with the anticipatory grieving and dealing with the feelings of grief. Being active gives the family members a purpose and helps them to make sense of what is happening. This helps with reshaping their lives and find new meaning in life without their family member (Davidson,…
According to Provision 2 of Code of Ethics for Nurses (2015), “the nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population,” (Brown, Lachman, & Swanson, 2015, p. 269). An interpretation of this provision is that the nurse cares for, and is committed to, patient and family. Provision 2 also explains that the patient’s family should be allowed and encouraged to participate in the care of their loved one (Brown, Lachman, & Swanson, 2015). I am reminded of a time during my clinical when my patient’s mother was such a big part of my patient’s care. My patient had been sick for many years already and his mom was clearly on top of every treatment and plan of care. My patient’s mom learned everything…
This article present a case in which the patient and the family made a decision in favor of resuscitation that ran contrary to the physician’s medical judgement. The author argues that, where a patient request for treatment in conflict with physician’s responsibility to provide what he or she believes to be good medical care, a resort to autonomy alone is insufficient. The principal of autonomy, which allow patient to refuse any procedure or choose among different beneficial treatment, does not allow them to demand nonbeneficial and potentially harmful procedure. This is important because CPR should not be considered an alternative to be offered by physicians in such cases. Instead, the physician should have listened to the patient’s hopes and fears, reassured him that the physician should would continue to be there and provide appropriate therapy, and, if necessary, refer the patient to psychiatric personnel or clergy.…
This study aimed at finding out the perception of emergency room staff nurses on family witnessed resuscitation (FWR) practice. The first objective is to describe the resuscitation skills of the emergency room nurses. The second objective is to determine the benefits and barriers of family witnessed resuscitation practice as perceived by the nurses. The third objective is to examine the status of emergency room nurses in terms of length of experience as emergency room nurses, number of times the emergency room nurses have attended a family witnessed resuscitation, and number of life-saving trainings attended. The fourth is to determine the perception of emergency room nurses having family witnessed resuscitation practice in terms of ethical…
The death of a child can be devastating and it is essential for the parents to receive support from the medical staff while at the…
In the clinical setting, nurses also encounter ethical dilemmas regarding patient care that do not appear to have a potentially simple solution (Fant, 2012). Such as, a patient’s family…
Often times as the patient’s advocate the nurse feels that he or she may know what’s best or what the patient would want. By being at the bedside of many patients’ in similar situations nurses see what the patients are put through during life sustaining acts. Sometimes these acts are more traumatic than the illness that brought the patient into the hospital; many times in the emergency room this writer has heard nurses say, things like “we’re not doing them any favors.” This saying is normally when uttered when CPR is in progress or has brought back a patient that has a poor…
Evidence-Based Practice, Step by Step: Asking the Clinical Question: A Key Step in Evidence-Based Practice…
post-arrest. This research could improve all practices by prolonging the life of cardiac arrest patients. As most of these patients die from the lack of oxygen to the brain, being able to preserve the brain tissue will lead to more desired outcomes and decrease the mortality rate associated.…
Life in the emergency room is can be fast paced, with decisions made by healthcare professionals who need to consider the basic ethical principles of non-maleficence, beneficence, autonomy and justice. These principles are resources designed and intended to provide a comprehensive understanding, guidance and rules of conduct to ensure an ethical and legal decision is made, regardless of the medical staffs subjective view of what is right and wrong (Tong, 2007, p. 7)…
Dr. Malesker is part of a critical care team where patients will present to the ICU with a critical illness. The situation is further complicated when the family members of the patient cannot decide what to do for the patient. The patients will present without previously informing their families about the kind of end-of-life care they want. This is where the case becomes an ethical issue, when the patient’s autonomy and ability to make their own decisions is compromised. With the differing opinions between family members, it further complicates the ethical issue.…
Have you ever wondered in an emergency situation as you are lying there on your death bed or in critical condition unable to make conscious decisions, who would give consent for your medical treatment? In emergency situations, there may be insufficient time for potential research participants to engage in the usual informed consent process. Furthermore, the emergency situation may impair the ability of potential participants and their representatives to make informed decisions because of anxiety, pain, or impaired consciousness. Waiting on consent could mean life or death.…
When loved ones are admitted to a critical care area, the effect on the family as a unit can be serious and long term. Traditional rules for this area have not been advantageous to meeting the needs of the client with inclusion of the family and significant others, but have served as a shield for the healthcare staff. Research shows barriers in meeting the needs of family members that require solutions based on evidence rather than tradition.…
Death is a touchy subject. People pretend it is something that does not happen and refuse to talk about or address it. I am an ICU nurse. I have been for six years. I have dealt with plenty of death, in my own way. Death is a part of life. Whether it is something that is expected or not, it is our destiny. Having dealt with the suicide of my son’s father at a young age, death is something most of us avoid or do not expect. One is never prepared for it. Some refuse to accept it and move forward.Whether it is a loved one battling cancer for multiple years or a sudden suicide/death, it is never acceptable. Working in the ICU, I have seen many a prolonged death. Family members are never prepared for the death of a loved one. Whether or not my patient is ready to move on, family will do everything possible to prolong the death in hopes that the patient’s condition will improve or a “new” cure will save their lives. I have gone through spending an hour resuscitating a 20 year old with severe congestive heart failure to taking my time resuscitating a 98 year old riddled with cancer. Regardless of my beliefs, it is never easy for family members to accept their loved ones are no longer among us. I have mixed views about death regarding a person battling cancer. Many a times I have had a patient who is a “full code,” all life saving efforts to be attempted, that has metastasis of cancer to their liver, brain, and bones requesting all life saving efforts. In the medical community, we know life saving efforts are futile. The patient is in so much pain they can hardly stand it. They have no quality of life. Family members are hopeful that some medication will take effect and the cancer will disappear. But, by law, we are to make every effort possible at resuscitation. If a person has a good prognosis in surviving cancer, every effort should be made to prolong the person’s life. If the cancer has metastized and is now affecting other organs, brain, bone…