Patient's and Advance Directives

[almostthere2]

Is there anything that nurses can do to protect the rights of a patient concerning their Advance Directive when a family member is trying to overturn the patient's wishes?

[imintrouble, BSN, RN]

Believe it or not, the best chance the advance directives will be followed is the MD. Though most docs will do whatever the family wants. Won't even raise an objection. Even when there is a written signed legal document.

The MD must order any life saving intervention for the pt. If the MD doesn't order it, it won't be done. The family of course can choose to change MDs or hospitals.

I'm sure there are lengthy legal avenues to explore, but I've not ever seen either family or MD involve themselves in that.

[SolaireSolstice, BSN, RN]

The hospital I work at has an ethics commitee that would, and has addressed these sorts of issues.

[Tait, MSN, RN]

Ethics committee and the MD would be my route.

[steelydanfan]

You have a duty to bring ANY attempts to negate a DPOA immediately to the Ethics committee. It says so in your states practice act, that you will be at all times an advocate for the PATIENT.

The doctor is not the best advocate for the pt. I have seen them go against EVERYTHING the pt. wrote or expressed, due to family or personal beliefs.

[muffins20]

I've wondered about this before too. I imagine it'll happen to a nurse sooner or later. While the ethics committee is trying to resolve the issue, how does the nurse on floor carry out care for the patient then? Follow MD orders even if they are against the AD or continue being an advocate for the patient and their AD?

[steelydanfan]

I've wondered about this before too. I imagine it'll happen to a nurse sooner or later. While the ethics committee is trying to resolve the issue, how does the nurse on floor carry out care for the patient then? Follow MD orders even if they are against the AD or continue being an advocate for the patient and their AD?

Once you have brought the matter up to the EC, they will review the chart and give you guidelines, usually it is to follow orders with the caveat that they have been notified. Document as such.

[marypaige]

Advance directives center around the principles of a person's right to die and death with dignity. With an advance directive, a person can express how much or how little he or she wants when he or she is no longer able to make these decisions. Also, these are legal documents in which the patient convey his or her decisions about end-of-life ahead of time. This shun confusion later on. Furthermore, outside the health care facility setting, bear in mind that never assume that concerns of the assets - however humble - will sort themselves out before the person kick the bucket. Therefore, learn about the documents the person need before they die. Check this out: Prepare the documents you need before you die.