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daters 494 Views

Joined: Sep 11, '05; Posts: 1 (0% Liked)

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    Hello everyone in Nursing Land,
    I have been reading with interest these articles and they raise some very emotive responses. After 35+ years nursing, I still wonder why, as a profession as Doctors and Nurses, we actually ask families what they want us to do in these situations or offer them a choice. Generally, unless you are dealing with medical people in the family, the general public do not have an understanding of the issues that the Code team may be faced with. They generally do not have our training or knowledge of medical issues and cannot make an informed decision or even a choice based on anything other than a desire to see their loved one returned to them. I understand how difficult these scenarios are, but the burden of guilt that some families may carry after making some decision to continue OR withdraw must be huge and unbearable. Sometimes, I feel it would be so much better to tell families exactly the state of play and to let them off the hook so to speak. As an example, the following imagined scenarios "Your 'relative' is very ill. He has problems with his lungs, his heart and his digestive system. We also have issues trying to treat an overwhelming infection. We are using maximum anitibiotic cover to assist and as many drugs as we can in this situation. We have to tell you that we are very concerned that we are not winning the battle as your relative was very ill to begin with and they may not have the reserves to help us win. We are going to continue to try as best we can to do everything we can, but we wanted to let you know how serious the situation is. We will keep you informed of events on a daily basis and you may speak with us and ask questions at any time. At no point, will you be asked to make a decision regarding whether to turn off life support as that is a decision that the patient may make for himself as far as his condition dicatates, but we will continue to try to assist in every way possible.

    I have been in situations where families have made ludicrous decision and make the burden upon staff impossible. Attempting to save 97 year old grandmothes who obviously have reached their term of life and who probably have accepted themselves that their earthyly life is now over. The environment produced by a family demanding that everything possible is done, whilst documenting everything that is said and done with the patient, is nothing less than harrassing, frustrating, demeaning and all but intolerable. Unreasonable expectations of the family are often not met and lead to complaints, verbal abuse and unnecessary intimidation of staff and I believe should be dealt with at the earliest possible moment. Very hard when you may not know what you are dealing with in the first instance.

    What do you think??