Published Feb 22, 2009
Orenda
31 Posts
It was one of my clinical rotation at a hospital and the patient was a 60yr old male who got into the car accident three days ago. The doctors recommended the family to removed the life support because he is not going to recovered. The family finally decided to removed the life support. As a nursing student following the nurse, the nurse asked me to removed the intubation tube with her. I was shock to find out I have to do it. I explained to her that I do not think I am ready to do this act. I'm not sure whether to believe it is right to removed the tube on him. I don't know if I have violated my belief. The nurse went and talked to my clinical instructor. My clinical instructor came and talked to me. I explained to her that I am shock to see they decided to removed the tube after three days. I also told her that I do not think my religion allowed the act of removing the tube. The instructor said she does not understand why I am so emotional. She then later asked a chaplain to come and talk to me in person about my feeling. I felt as if I have done something very wrong. Did I behaved inappropriate in this situation?
dnp2004
106 Posts
You did not do any thing wrong. You told them why you could not remove the tube. As for your emotional state, I see why you were upset. You actions would have terminated all life in the patient. If that is not emotional, I don't no what is!!!
JBudd, MSN
3,836 Posts
I don't think this is something I would have asked a student to do; its just too early in your "nursing" life to cope with.
The nurse may have thought she was letting you do a task that is interesting to learn to do, and the opportunity doesn't arise very often. More often, extubating is done on someone who is awake and ready to breathe on their own, and needs to be done quickly and efficiently. Learning to do it on someone you can't hurt, well, its good practice.
Removing life support is not done quickly or easily; three days is not unreasonable when there is permanent damage and no chance of recovery. The fact that the family was willing should tell you a lot. You are not killing him. Fultile care is just that, futile. It is something we all come face to face with at some point, when to stop.
I think your instructor responded appropriately, she asked you about your feelings and got emotional support for you. Nursing is tough, and sometimes we need to learn more about ourselves and our own reactions before we can fully care for others.
God bless, and I hope things become a little clearer for you over time.:redbeathe
TinkerNurse
80 Posts
I don't think you did anything wrong. If you had shown NO emotion about removing the tube THEN I would be concerned.
Am_Byth
50 Posts
Were they upset about your emotions or your refusal to remove the tube?
I think the nurse was upset because I refused to help with the extubation and my clinical was upset about how I reacted to the situation.
How will you react when you are a nurse and have to do that?
Jolie, BSN
6,375 Posts
You actions would have terminated all life in the patient. I don't want to sound like I am splitting hairs, but I respectfully disagree with this statement. The patient was being kept "artificially" alive with the use of extraordinary technology. His body was not capable of sustaining life on its own, and had no realistic hope of recovering. Removing that technology is not terminating the life of the patient. It is simply removing the barriers to a natural death.To terminate the life of the patient is to make a deliberate act that causes death, such as administering an intentional overdose.There is a difference, legally, ethically and morally.To the OP, I commend you for speaking up about your religious beliefs and your moral inability to participate in removing the breathing tube. If you are strong enough as a student to speak up for your beliefs, you will do likewise as a professional on behalf of your patients. I believe it was inappropriate to engage a student in the act of removing the breathing tube. As professional nurses, we have had the opportunity to think thru the process and decide whether or not our conscience allows us to participate in this. Students have not likely had that opportunity and should not be pressured to be involved in life-support removal, abortion, or other morally-challenging issues without prior notice and the opportunity to decline.
I don't want to sound like I am splitting hairs, but I respectfully disagree with this statement. The patient was being kept "artificially" alive with the use of extraordinary technology. His body was not capable of sustaining life on its own, and had no realistic hope of recovering. Removing that technology is not terminating the life of the patient. It is simply removing the barriers to a natural death.
To terminate the life of the patient is to make a deliberate act that causes death, such as administering an intentional overdose.
There is a difference, legally, ethically and morally.
To the OP, I commend you for speaking up about your religious beliefs and your moral inability to participate in removing the breathing tube. If you are strong enough as a student to speak up for your beliefs, you will do likewise as a professional on behalf of your patients. I believe it was inappropriate to engage a student in the act of removing the breathing tube. As professional nurses, we have had the opportunity to think thru the process and decide whether or not our conscience allows us to participate in this. Students have not likely had that opportunity and should not be pressured to be involved in life-support removal, abortion, or other morally-challenging issues without prior notice and the opportunity to decline.
No health care provider should have to remove life support. For those who object, on religious or moral grounds, others can step in.
ghillbert, MSN, NP
3,796 Posts
Which religious belief does this cause conflict with? If the man is going to live, he'll keep breathing when the tube is removed. Would you have removed an IV? I don't really see the difference.
Thank you everyone for your comments. If I'm a nurse I would reacted differently because I believe I am more experienced in term of where I stand on certain sensitive issues. As for now, I'm still sorting out where my stand is on this issue.
netglow, ASN, RN
4,412 Posts
I see a little insensitivity/poor prep. on the part of both your RN and clinical instructor. Curious, what level in school are you? I would think that taking you aside, preparing you with a little info, and a direct question as to whether you think you can handle this, if so, now's the time to get it together before we re-enter the room... type of quick conversation -- would have been appropriate. Especially if family was near. :heartbeat