Advice please: Withdrawal of feeding tube

[Clubsingr28]

Hello Nurses,

I am having a serious personal inner struggle with a current issue at work. "Mrs. G" (who is 79) had a CVA last year with resultant hemiplegia & dysphagia. Subsequently she became a LTC resident of mine after her hospital stay. She came to us with a PEG and receives bolus feeds. She is cared for by CNAs and hoyered into a recliner where she watches TV, listens to her classical music and reads the paper on a daily basis. She is able to say a few words such as "yes, no, not now, oh, ok", etc. Actually just recently has been saying a few new words. She does not have dementia but her husband has been her medical POA. She was doing so well we had speech consult with her just last week and she passed her 1st swallow eval. with flying colors. (Mr. and Mrs. G are financially wealthy people, the opera, theater, and fine dining were a BIG part of Mrs. G's enjoyment in life)...

So, the VERY NEXT DAY, her husband, (the healthy one who lived at home) passed away. Her husband was her biggest advocate. I never even had the chance to tell him how well she did during the swallow eval, he would have been excited)-- Now her 2 sons, who have hardly been in to visit her now have medical POA. (One I'd never met because he admittedly has only been in once in the past year and the other one maybe 3-5 times over the past year)-

Well yesterday the came in to tell "Mrs. G" that her husband had passed away BUT when they arrived she was not feeling well. They asked me what was wrong and I told them she had a UTI- They talked between themselves a few minutes then asked if there was a doc they could speak to.. I responded yes then went to get her. 30 minutes later the MD came to me with tears in her eyes and handed me a new Advanced Directive and told me to D/C Mrs. G's TUBE FEED FORMULA AND that we would NOT be starting the MACROBID so NO TX FOR THE UTI EITHER.... then she said the sons want to put her on hospice.

1) Mrs. G- is not aware of any of this...

2) She was medically stable other than the UTI

3) She does have some quality of life, enjoys music, company, newspaper, etc..

4) She had JUST started eating small amt. during her eval- MD d/c'd speech consult too

Nurses I need your opinions, PLEASE, and ALL will be respected...

Thank you!!

Kelly, RN in NY

[Esme12, ASN, BSN, RN]

You did good!!!! you do the profession proud.

Your DON seems like she's a peach...sarcasm meant.

You can still call the states ombudsman and get an advocate to remove you from being a target for your DON. New York State Office for the Aging Ombudsman|Caregiver|Nursing Home Complaints|Nursing Home Problems

[just.me]

well done & great work clubsingr28, your residents are lucky to have you!

[ktwlpn, LPN]

>>>>

And your DON says you are "too emotionally involved"? She has clearly lost her ability to remain impartial. Sure,she says she would make the choice to die if she were in this position but she can't make that choice for the resident. Be prepared for blowback from her and be prepared to call the Ombudsman to protect the resident.

[eagle78]

I must say that you have done a wonderful job advocating for your patient. This situation reinforces my admiration for the nurses at the LTC's. I can say from personal experience that the time and attention given to the patients by the HCP's is priceless. In addition I know for a fact that attention is paid to the family as well. After my father passed, I could not go back in to the home because it was just to overwhelming to go back where he made his transisition. My mother goes periodically to show how much she appreicates their diligence in caring for my father. She says the nurses were very concerned about my emotional state because they could tell I was very close to my father, consequently they always ask how I am doing. Guess I will have to go up there one day just to give them a great big thank you. So, thanks for all you do, it makes a diffeence.

[ktwlpn, LPN]

How are things going with your resident?