Ethics Case

[nursenugs]

Hello! I have an ethics presentation coming up about the following case. I have to present it from the perspective of the nurses. I have already completed most of the project but am having trouble coming up with solutions to the issue, which can be either decisions or outcomes. What would you guys do?

The nurses on a surgical intensive care unit are highly-skilled and competent professionals who take great pride in the quality of care they deliver their patients, and the unit is renowned for its excellent patient outcomes. Recently, the hospital has hired a new liver transplant surgeon charged with developing a liver transplant service. The patients who are admitted to this service are very ill and early surgical outcomes have been very poor. After a few months, the nurses express mounting concern and frustration in caring for these patients. Many of the transplant patients become chronic with stays in excess of two months, and despite the care they receive, they have little hope of surviving. Yet, the physicians continue to admit these patients, and do complex treatments that take much nursing time and resource. Their view is that the patients have placed their trust in them and they are obligated to do anything and everything for these patients to ensure their survival. The nurses state that they believe it is wrong to spend so much time, expense, and personnel in caring for these patients, especially when there is so little chance of survival.

[traumaRUs, MSN, APRN]

Hmmm....I think ethics is a very difficult concept. There is usually no absolute right or wrong. What did you come up with so far for an answer? Or...what pieces have you formulated from the case?

[nursenugs]

I actually found a really awesome article last night about a shared decision making model thats being implemented at MD Anderson for renal patients that works quite nicely when tweaked for the liver so I went with that. However, I would still be interested in hearing if anyone has any other ideas!