Please help with case study for Nursing School

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Here is the case scenario.

You have been working in the Critical Care unit for 18 months. one evening john, a 40 year old male patient, was admitted with a serious head injury. He has a history of mental illness and has been living with his 80 year old parents for the last 15 years

After being on life support for 3 days his parents came to the unit and stated they wanted everything stopped and to have him removed from life support. After taking the appropriate measures, the team began to remove the life support equipment. After removing the breathing tube, john opened his eyes and loojked at his family and said " why are trying to kill me?"

as the nurse assigned to john, what do you do?

please help

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Specializes in Med/Surg, Ortho, ASC.

What are your ideas?

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Wow, i wouldn't know what to say to him.

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I agree, we're not here to do your homework for you. Perhaps if you post what YOU think you should do, other people might be willing to chime in and let you know if you are on the right track or not and then give you some pointers.

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Specializes in Case Management.

I agree that I don't want to help with homework; then what would you be learning? To ask here next time you have a difficult question? Better to try out those critical thinking skills and decide on your own what you would do.

There are clues in the question, you need to break it down and consider every angle. There are several issues here and you have to prioritize.

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Specializes in ICU/CCU.

I keep a small cake, party hats, and noise makers on hand for just this sort of situation. You whip out the cake, plop a hat on his head, and yell, "SURPRISE!!!! We had planned this surprise party for you, but we knew you wouldn't be able to eat the cake with that ET tube in, so we had you extubated. YAY!!!" If he tries to say anything else just drown it out with the noise makers, and please do not use real candles around oxygen.

Boy, I wish that I'd known about this site when I was a student. It would have made all the difference.

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I don't want anyone to do it for me...its a shocking case scenario..I personally would know what to do in this situation other then til the doctor. It's also a lil personal because I have to make the decision to put my mom in hospice after she had liver cancer and had kidney failure. So I'm a lil lost that's why I wanted someone else option

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To add its not homework and I haven't seen started nursing school its for a scholarship for nursing school..which makes it difficult to evaluate the situation from a nursing student perspective so please don't be so judgemental. If ur going to help then help if not please do not post!!!! Thanks

I'm personally thoughts would be

*to maintain treatment on John

* discuss other options for john with his parents for current treatment I'm the hospital and option for assisted living for him after he leaves the hospital to remove some of the responsible from his elderly parents.

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Specializes in Med/Surg.
To add its not homework and I haven't seen started nursing school its for a scholarship for nursing school..which makes it difficult to evaluate the situation from a nursing student perspective so please don't be so judgemental. If ur going to help then help if not please do not post!!!! Thanks

I'm personally thoughts would be

*to maintain treatment on John

* discuss other options for john with his parents for current treatment I'm the hospital and option for assisted living for him after he leaves the hospital to remove some of the responsible from his elderly parents.

Honestly, not to be harsh, but that makes it WORSE to be asking, not better! The POINT is that it's difficult to answer; the persons awarding the scholarship want to know those who they award scholarships to, and this is how they're doing it. They want to see how you critically think, number one, to see how you'll fare once you start NS. They want a sense of the type of person you are. Getting any answers from here, both from new and seasoned nurses, takes away from their ability to see and evaluate if they'd like to help finance your nursing education.

There isn't a "right" answer, that's why it's such an open-ended question. Answer it honestly and to the best of your ability. That's the only advice anyone here can truly give you.

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Specializes in mental health, military nursing.

Sorry, John, it's what your parents want! *yank*

This is a silly scenario. Mental illness does not equal mental incompetence - if the guy wakes up, he gets to call the shots. Heck, even if he's mentally incompetent, if he's cognizant, no one is going to pull the plug on him. If the parents still want life support stopped once he wakes up and is talking to them, I'd begin questioning how he got that traumatic head injury :D

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Specializes in Acute rehab, LTC, Community Health.

Hi, I'm sorry you are having a difficult time with this case study. In all fairness, I don't think critical thinking skills are something that one just has per se, but are developed over time with experience. My thoughts are that if the patient can communicate by speaking, possibly he can communicate some other way? He could be reintubated and given an opportunity to meet with his family and an ethics committee to discuss his wishes, by say blinking to answer yes or no, a communication board or some other means. Either way, I would research ethics committees, because I would say one definitely needs to be contacted in this situation. Good luck on your scholarship and your endeavors in nursing, it's a great and exciting career!

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Specializes in Gerontology, nursing education.

If this is for a scholarship, then it's even more important for you to give the best answer that you can come up with on your own. Some of your peers and even some of your instructors might be on this forum and if a classmate or an instructor would find a student posting homework questions or, worse, test questions and answers, it could be construed as academic dishonesty and get that student in a LOT of trouble.

If you are a pre-nursing student applying for a scholarship, you don't want to give an answer that would be too close to what a practicing, experienced nurse would say. The people who are evaluating you for that scholarship want the truth----your best answer as a pre-nursing student----not a consensus from experienced nurses or other students.

I am not saying this to be harsh or judgmental; rather I am trying to save your butt here. You may wish to ask a moderator to close this thread because if anyone from your scholarship committee sees it, you could be denied that scholarship.

You don't have to be a dishonest person to be accused of academic dishonesty---sometimes all it takes is just one naive question or doing something without thinking. I don't want to see that happen to you.

Good luck and I hope you get that scholarship!

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