POA and A Nurse Role

[NurseC1986]

Hi everyone. I know had what I considered to be a very important question. How much power do Power of Attorney's really have? Of course we can document until our fingers fall off but can we be reprimanded for not sending someone out to the hospital who will die without further interventions? What are our responsibilities as a nurse to ensure safety if the Power of Attorney is refusing care at all? Did I mention the patient is deemed incompetent to make their own decisions? And if a POA is trying to do harm by withholding treatment can THEY be deemed unfit to serve as their POA? If any of you have an opinion I would grately appreciate it.

[JKL33]

NurseC1986 said:

And if a POA is trying to do harm by withholding treatment can THEY be deemed unfit to serve as their POA? If any of you have an opinion I would grately appreciate it.

Good question.

My belief (others can correct if I'm on the wrong track) is that you are a mandatory reporter of abuse/neglect of vulnerable persons.

So if you really feel that your take on the situation is accurate (that there indeed is some intent to harm by withholding treatment) you would report to the appropriate agency.

I do think there are some nuances, and it is not unusual for nurses and others to have conflicting feelings about some types of care being withheld. My recommendation would be to first discuss your concerns with your DON/manager/supervisor who knows the situation. It may be that the POA is making reasonable choices given the situation on the whole.

[AnnieOaklyRN, BSN, RN, EMT-P]

Have you ever thought that the POA is actually obeying the patient's wishes, which may have been not to prolong their life?

Why do we not respect that patients have the right to die, and constantly intervening is worse than letting nature take its course. If the patient is in pain, then yes by all means attempt to treat it, but respect the decision of the POA because chances are they had a conversation with the patient when he or she was coherent!!!

Annie

[NurseC1986]

Very true. Thank you for your input. The upper management is aware. I have not seen with my own eyes that there is actual harm being done, however some people have brought to my attention some remarks made which are highly inappropriate. But as I said I have not heard anything myself. So as of for at least right now I can't say that I know something is going on.

[MunoRN, RN]

The POA has the exact same decision making abilities as the patient themselves, we do have the responsibility to ensure that the POA is making the decisions that to the best of their knowledge the patient would be making if capable of doing so, but there is certainly no requirement that the POA always decide on the most aggressive measures possible if that's not what the patient would have chosen.

There's nothing inherently inappropriate about not wanting to be sent out to the hospital, no matter how sick they might be, for many patients that just isn't beneficial overall and going to hospital arguably has more potential for harm than not going.