HELP!! What about what the PATIENT WANTS?????

[AtlantaRN]

Marketer calls office, need to eval pt at local hospital-SEE IF SHE MEETS GENERAL INPATIENT CRITERIA,

dtr wants nh placement........

I meet md coming out of patients room, md states "does not want hospice..." dr writes note stating

patient understands she has stage IV ca, has had life threatening reactions to previous treatment, still

wants aggressive treatment, does NOT want to be made comfortable. Note even states patient wishes

to be referred to local "teaching" hospital well known in Georgia for clinical trials.........GI doc who visited just

1 hr prior writes "patient wishes to be followed by oncology for aggressive treatment??" and STILL writes

and order for hospice.....WHAT ABOUT WHAT THE PATIENT WANTS?????? Even if it is futile......

would you insult this pt by going in the room and trying to sell her on hospice, right after she has

emphatically expressed her wishes to the physician?????? I won't.......I read the note to my manager and told

her i would not insult the patient by trying to sell her on something she emphatically does not want.......

now, I will follow up on saturday and sunday with calls to the hospital, but I refuse to insult this patients

intelligence just because the daughter wants nursing home placement.... They have totally removed the

patient wishes out of the picture. even the case manager at the hospital writes what DAUGHTER wants....

but never consulted with the patient. Primary nurse states patient is alert and oriented.

Thank you for your input.

[tewdles, RN]

Why not present palliative care to pt? Palliative doesn't necessarily mean terminal (even though in her case it appears to be) That way physical needs and symptoms could be managed and she could still receive aggressive treatment as per her wishes. So many times with issues like this, it's the way the DOCTORS present the information to the patient. They don't take time to listen to what is being said by pts. or families. If she goes to a large teaching hospital, they will have a palliative care team that can help to find solutions to these issues.

That is a good suggestion, however there are many communities with very limited (if any) access to palliative medicine practices...IMHO.

[AtlantaRN, RN]

Still a full code....still gip but declining

[blueheaven]

That is a good suggestion, however there are many communities with very limited (if any) access to palliative medicine practices...IMHO.

I know but since I didn't know where this person lived, I had to throw it out there as a suggestion. IMHO

[AtlantaRN, RN]

she is still on service, and now glad she accepted hospice