Fellow nurses, I recently was involved in a case where I feel that there was a terrible breach of ethics and it still has me upset. I will be vague to protect the privacy of those involved; there is a complicated back story but the gist of it is:
Patient is actively dying with no hope of recovery- not a candidate for dialysis and in severe renal failure, volume overloaded, profusely bleeding esophageal varices, tachypneic, sounds as though they are breathing under water- you don't need a stethoscope to hear it, looking miserable and exhibiting air hunger and pain behaviors.
MD refuses to write for comfort measures and withdraw futile treatments including IV FLUIDS on an anuric, volume-overloaded patient because they want to keep patient alive for the next-of-kin (who the patient had previously expressed was not the person they wanted making decisions for them but because the MD had declared the patient incompetent this wish was dismissed). Next of kin was supposed to come in the morning and still hadn't arrived by 8 pm. (I refused to continue the IV fluids and eventually MD relented)
I contacted the nursing supervisor and ethics and the Ethics on-call agreed with me and contacted the MD but nothing was done. I paged the MD about 6 times and they stopped returning my pages. The charge nurse and social worker got involved and paged the MD. Every single person agreed that this was cruel (including the MD) but the MD wouldn't listen and actually started a sentence "Ethics are nice but...."
I don't know how this ended as I left when my shift was over. I don't know what to do with this. This is a new MD and I know my relationship with them has gotten off to a terrible start-esp. since I went over their head and there will probably be repercussions for them. I also don't trust this person to act in the best interest of their patient now although I am going to do my best to start over with a clean slate.
This is my day off and I still feel drained and angry. I need to let it go. Words of encouragement would be nice. I hate feeling as though I have failed my patient even though I did everything I could think of.