nursewing.com
             
nursing articles

nursing articles

nursing articles

nursing articles

nursing articles
 
"Nursewing Guide"
   
  Buy Nursing Gifts
» Nurses: RNs, LPNs, CNAs
» Nurse Tech Gifts
» Medical Assistant Gifts
» Medical Doctor Gifts
» Nurse Manager Gifts
» Nursing Specialty Gifts
» Student Nurse Gifts
» Male Nurse Gifts
» National Nurses Week  
» Nursing Graduation Gifts
» NEW: Nursing Watches
   
  Nursing Poetry
» Buy Text Only Poems
» Online Poetry Shop
» Poems in Gift Format
» Poetry Collections
» Writing Software
» Nursing Poems
» Submit Your Poem
» RNs, LPNs, CNAs Poems
   
  Online Degrees
» LPN to RN Degree
» RN to BSN Degree
» RN to MSN Degree
» PhD Degrees
» Midwifery Degree
» Law Degree Option
» Nursing Degrees
   
  Online Certificates
» Case Manager
» Forensic Nurse
» Gerontology Certificate
» Health Informatics
» Legal Nurse Consultant
   
  EMS Degrees
» Paramedic to RN Degree
» EMS Management Degree
» Fire Science Degree
» Law Degree Option
   
  Popular Poems
» Tribute to an RN
» Tribute to a Hospice Nurse
» Tribute to a Nursing Student
» Tribute to a Nursing Instructor
» Tribute to a Pediatric Nurse
   
  Top Online Schools
» Capella University
» College Network
» Concord Law School
» Kaplan University
» Walden University
   
  Nursing Resources
» Nursing Articles
» Nursing Blog
» Nursing Books
» Nursing CEUs
» Nursing Essay Help
» Nurse Job Search
» Nursing Journals
» Nursing Links
» Nursing Loans
» Nursing Resumes
» Nursing Scrubs
» Nursing Watches
   
» National Dates
» Affordable Dental Plans
» Disaster Preparedness
» What's New at Nursewing
   
  Credit & Loans
» Auto Loans
» Credit Cards
» Credit Reports
» Online Loans
   
  Nursing Associations
» Associations by State
» Associations by Specialty
   
  More Online Degrees
  For more online degree
options visit our sistersite 
OnlineStudyPrograms.com


Scripture of the Day

Have not I commanded thee? Be strong and of a good courage; be not afraid, neither be thou dismayed, for the Lord thy God is with thee whithersoever thou goest.”                    KJV (Joshua 1:9)

 

Nurses are more
Than people in white.
They are mediators,
between human suffering
and human wellness;
Where what they do
Goes far beyond
What is seen.

Author...
E. V. Stankowski, RN
Join our newsletter, and get the latest news from our website delivered directly to your inbox!

 

Search Nursing Jobs

Post Your Resume

 

View Evie Stankowski's profile on LinkedIn

Follow nursewingpoems on Twitter


 

 
nursing degrees online

Title: The Decision to Withdraw Care / Clinical/Ethical Exemplar
Author: Heather N. Miller, RN

Date Posted:

May 3, 2011

The Decision to Withdraw Care

As a nurse, there are those few patients that stay forever in your mind. Due to either the family or the patient they make a lasting impression. Several months ago I admitted a patient that had been in an automobile accident. She was an 88 year old restrained, female driver. She received multiple bilateral rib fractures, bilateral pneumothorax, liver laceration, and a small cerebral hemorrhage. She had been intubated due to respiratory failure and had bilateral chest tubes.

When I received report from the ER, the nurse told me that the family stated that the patient was a DNR, but the family was going home to get the DNR paperwork. The patient at this point did not have a hospital DNR. I received the patient at about 4pm, she was intubated and her vital signs were stable at this point. .

After she had been there about thirty minutes, her blood pressure dropped to the 60’s systolic. We received an order to hang a normal saline 1 liter bolus and to draw a stat H&H. The doctor had also stated on the phone that he thought the family was going to decide to withdraw care on the patient. During the normal saline bolus her blood pressure rose to normal limits and stabilized there. When we got her lab results back her hemoglobin was 6. We then received an order to transfuse the patient with 3 units of PRBC’s. .

The patients son and daughter-in-law had come up to see the patient in the mean time. They had the paperwork they said was the DNR. The papers they brought were actually a living will that stated that she didn’t want to live by feeding tubes if she was in a non-recoverable state. It also stated her son to be the health care surrogate decision maker. The doctor came up to talk to the family about the patients condition. He told them that she had extensive injuries and due to her age he didn’t think she would recover from them. If she did recover from them, he said it would take months for her lungs to fully recover. The family stated that they wanted to give her a couple of days to see how she would do, but if she didn’t improve that they would withdraw care. .

The next day, the family made her a DNR, but still didn’t want to withdraw care at this point. A few days later, the patient had improved slightly, but the entire family had decided that they wanted to withdraw care. The doctors were informed of this, but at this time didn’t think it was ethical to withdraw care due to the patients living will. They thought that eventually she might recover and her living stated that she didn’t want to be kept alive if she was in a non-recoverable state. .

The ethics committee got involved in this case. I explained to them how the family was approached in the beginning about withdrawing care and that now that the family wanted to withdraw care they were being denied there wishes. After a few days, they all decided that even though her living will didn’t clearly state it, she would not have wanted to live like this. The doctor’s and ethics committee agreed to let the family have their wishes and to withdraw care on the patient. .

I was very upset with how this situation was handled. The fact that the family was approached with withdrawing care in the beginning, and then to have it denied to them I don’t think was fair. It took a lot for them to make that decision. It made the family feel as though they were doing something wrong.


About the Author: Heather N. Miller, an RN for 9 years, presently works in PACU at a trauma center in Florida. Her past nursing experience also includes Neuro ICU. She is married to a Firefighter-Paramedic and is the mother of 2 beautiful little boys.
 

If you are an author or have written articles related to nursing and would
like to post your article on this site, please E-mail: articles@nursewing.com

Choose Another Article Below or Return to Article Index Guide

nursing shortage

Solving the Nursing Shortage

infection control care

Five Steps to Effective Infection Control in Long Term Care

choosing a nursing home

Ten Things to Check When Shopping for a Nursing Home

nursing as a career

Strategies to Encourage Selection of Nursing as a Career

nursing shortage

Travel Nurses Provide One Solution To Nursing Shortage

nursing shortage

Shortage of UK Midwives – Real Reasons Revealed