Ethical Decisions

[NC_Gal]

What are some ethical decisions you were faced with while working in the nursing field?

[TheCommuter, BSN, RN]

Slow codes (full codes that were being conducted much more slowly than usual).

[EricJRN, MSN, RN]

Some of the toughtest decisions seem to hinge on whether or not to continue providing aggressive care to desperately ill patients. This can lead to the "slow codes" mentioned above.

[ktwlpn, LPN]

What are some ethical decisions you were faced with while working in the nursing field?

Back in the 80's my first full blown AIDS patient was married-his wife did not know his diagnosis and he wanted to keep it that way.

Everyone on the unit was really upset over the situation-I'll never forget it...

[S.T.A.C.E.Y, LPN]

Do Not Resusitate.....alot of people see it as Do Not Treat.

Old man with CHF exacerbation....Bipap may help push the fluid out of his lungs, but the doc says no because he is DNR. Intubation, Bipap, Antibiotics, ICU admission, etc.

[NC_Gal]

Given the following situation how would you respond?

An elderly woman, who's health is clearly quickly diminishing, is in a nursing home. Her dx is breast ca. She repeatedly asks what is wrong with her and keeps reminding you that she wants to go home. She yells for someone to help her, and you go to see what you can help her with. All that she says she needs help with is to know what is going on with her and what's wrong with her. But!!!, (BIG BUTT!! here) the resident's family, has made it VERY clear to everyone interacting with this woman, that she is NOT to know her dx of breast ca. How would you respond to this situation? Would you tell the woman what her dx is? Would you tell the woman that she needs to talk to her MD? Can they legally keep this woman in the dark about her own health an healthcare, since she is clearly askign about it?

[Diary/Dairy, RN]

Not sure - Does she have family to discuss it with???

Other ethical issues..... Why are all these 80+++ year old people full codes?? How much more time will we buy them with Vents, CPR and all the rest????

[NC_Gal]

This lady was also a full code, which just completly blew my mind! With health deteriorating so rapidly, plus the dx of breast ca. Her family would visit her often, but they were very specific about her not knowing her dx.

[Diary/Dairy, RN]

I really don't know what to tell you - respect their wishes or tell her the truth.....But is knowing going to help her or just stress her out?

[Diary/Dairy, RN]

Oh, forgot - also the family will be around a lot longer to deal with - a lot of times things are done with that in mind.

[NC_Gal]

I was just curious what others would have done in this situation. This happened at a place where I used to work as a CNA, before the demands of nursing school. Because I wasn't in a position to educate, or really even tell her about her condition, I never said too much to the woman about her dx, when she would ask what was wrong, I would tell her that was something she needed to speak with the nurse or the MD about when he came to visit.

[PurrRN]

My thought process is:

Is this 80-ish year old lady impeded some way with another Dx which undermines her cognitive abilities? If yes, then possible the descision to withhold the information by the family is a prudent one. If no, then highly unethical in my eyes. An A/O patient is always the one in control of their health descisions and information regarding thier care/dx (instead of family) regardless of their advanced age. Just because you are old doesn't mean you don't get the same rights as everyone else.