Note: This might seem like a strange topic, but seeing as how that is nothing new coming from the source, I'll go ahead anyway.
As nurses, we are trained to do everything we can to save someone until it's no longer feasible or unless doing so would go against a patient's wishes, such as performing CPR for a patient with a a DNR/DNI.
However, theoretically, anyone of us could "code" at anytime--and this includes at work.
For those who are full codes, this wouldn't create any ethical issues. You would simply perform CPR on your coworker as you would anyone else.
However, for those who have DNR/DNIs, issues could come up if coworkers are unaware such orders exist. How do we ensure that these coworkers have their wishes respected should the need come up?
For example, I am legally a Full Code but am wanting to pursue a DNR/DNI. Based on my age and no apparent health issues, I have a feeling most of my coworkers would automatically assume I am a Full Code should circumstances arise, however.
What is the best way to inform my coworkers that under no circumstances should anyone provide CPR to me?
For the rest of you, how do you ensure your coworkers' wishes for CPR or no CPR are ensured? Have you ever experienced such an ethical dilemma at work?
I figure if a code happens, it happens. At this time, I am single and childless so there's no real incentive for me to prevent any emergency of any kind. Unless, of course, said emergency involves one of my patients, but that's a different subject.
In your place of work, how do you treat patients who are having a mental health crisis?
In your place of work, how do you treat patients who are having a mental health crisis?
Depends. For some patients, a referral to the social worker and an outpatient therapy appointment may be appropriate. For others, a call to 911 and sending them into the ER if they are needing close/1:1 supervision might be required since our facility cannot provide such close supervision. Really goes on a case-by-case basis and most cases are easily managed within the facility.
Specializes in Psych (25 years), Medical (15 years).
12 minutes ago, sideshowstarlet said:
I have never met this coworker's twin sister.
I had really long hair and a beard years ago when I worked at a community mental health clinic. One time, a clean-shaven friend/co-worker stood next to me, took my long locks, and placed them over his bald head. He asked a nearby client, "Doesn't Dave look just like my twin brother?"
"I don't know", the client replied, deadpan, "I've never met your brother".
Depends. For some patients, a referral to the social worker and an outpatient therapy appointment may be appropriate. For others, a call to 911 and sending them into the ER if they are needing close/1:1 supervision might be required since our facility cannot provide such close supervision. Really goes on a case-by-case basis and most cases are easily managed within the facility.
And these patients- since you work in SNF/Rehab/LTC, would I be correct in assuming that at least some of them are widowed and don't plan to remarry or even have never been married? And that any children they may have had are adults by now, meaning that the patient no longer has the responsibility of providing for a family?
Is there maybe something else that, in your head, differentiates you from, for example, a widowed patient whose adult children rarely or never visit and no longer has/never had the responsibility of raising a family?
"I don't know", the client replied, deadpan, "I've never met your brother".
This coworker was really something else, though. Looking back, I almost wonder if she was sending her high-school dropout, drug-addicted twin sister in to work half of her shifts.
And these patients- since you work in SNF/Rehab/LTC, would I be correct in assuming that at least some of them are widowed and don't plan to remarry or even have never been married? And that any children they may have had are adults by now, meaning that the patient no longer has the responsibility of providing for a family?
Is there maybe something else that, in your head, differentiates you from, for example, a widowed patient whose adult children rarely or never visit and no longer has/never had the responsibility of raising a family?
That's right. It's not too common to have patients who were never married, although, of course, it has happened. However, we do accept quite a few patients who have deceased spouses. I doubt most, if any of them, are planning on getting remarried. Based on their ages, if they had children, they are all grown by now as well.
Specializes in Psych (25 years), Medical (15 years).
4 hours ago, sideshowstarlet said:
For a while, I was concerned about what this post and subsequent comments meant about the OP's mental health and had even flagged it for review by mods to be on the safe side. This isn't because I don't appreciate eccentric posts, but because there were some things that would have been genuine causes for concern had this been posted on a site like facebook, which has a mechanism for reporting content that indicates a risk for suicide/self-harm.
I truly appreciate your perspective, concern, and actions, sideshowstarlet.
If I believed there was cause for concern, or certain criteria was meant, I would act accordingly.
SilverBells' posts canned be summed up by what a respected psychiatrist said years ago:
"You can't admit somebody for just being weird."
And with all due love & respect for SilverBells, I am in no way using the word weird in a derogatory manner.
A Tom Robbins character in one of his novels was told he was weird. The character smiled and replied, "I believe I just require a little more understanding".
Those who are seen as weird by the mainstream merely require a little more understanding.
That's right. It's not too common to have patients who were never married, although, of course, it has happened. However, we do accept quite a few patients who have deceased spouses. I doubt most, if any of them, are planning on getting remarried. Based on their ages, if they had children, they are all grown by now as well.
And yet, in cases of mental health concerns/ unhealthy and concerning behaviors, you believe that intervening to provide relief, or at least prevent things from getting worse, is necessary and worthwhile.
What has led you to believe that it is worthwhile to prevent worsening health in an unmarried senior citizen who is finished raising children (if they ever had kids), but that it is not worthwhile to address mental and physical health concerns in a 30-something employed as an essential worker who, with appropriate support, can adopt a child one day even if she chooses not to marry?
Specializes in Psych (25 years), Medical (15 years).
1 hour ago, SilverBells said:
And my coworkers being aware of my wishes would make things easier for all.
Well you've proven your point, SilverBells, so take the steps necessary to do as you wish. A lawyer, as mine did, can draw up a specific circumstance DNR/DNI. The legal document can be copied by the PCP, as was mine.
I informed my coworkers, as I noted in my first post, and everyone knew my wishes.
So there's no need for further discussion, correct?
Well you've proven your point, SilverBells, so take the steps necessary to do as you wish. A lawyer, as mine did, can draw up a specific circumstance DNR/DNI. The legal document can be copied by the PCP, as was mine.
I informed my coworkers, as I noted in my first post, and everyone knew my wishes.
So there's no need for further discussion, correct?
Davey Do
10,666 Posts
ACT-SHOO-ALL-LEE, and with all due love & respect, CharleeFoxtrot, I prefer Emergent's label:
It's not that SilverBells is a "liar".
She merely has "a gift for fiction".
Or sensationalization.