Scenario:

Mr. M is a 66-year old male who was brought into the Emergency Department for heart failure and an exacerbation of chronic obstructive pulmonary disease. Upon arrival, Mr. M. was in respiratory distress and had altered level of consciousness. Mr. M. went into cardiac arrest. Subsequently, he was intubated. He was successfully revived and admitted to the Intensive Care Unit where you are working. Due to COVID, only one visitor is allowed in the ICU per day. The patients wife is at the bedside and is upset. Mrs. M explains to you that my husband would never want this ventilator. He always told me to never let this happen to him. No one notified me he was being intubated and I feel terrible.

Mr. M is on no sedation and only responds to painful stimuli. The medical provider speaks to Mrs. M and explains that her husband is in critical condition and has a poor prognosis due to his COPD and heart failure. Mrs. M explains that her husband did not want resuscitation or to be placed on a ventilator. The physician attempts to convince Mrs. M to wait and see how her husband responds. The medical provider feels in a few days Mr. M may recover or show signs of improvement.

Mrs. M. comes out to the nurses station and speaks to you. She states she feels sick to her stomach and could not get the doctor to understand her husbands wishes. She states that we often discussed with each other what we would or would not want if something happened. My husband always said he would never want to be on a ventilator. I feel like I have betrayed him.

Instructions:

In 300 words or more, discuss all of the following questions. Please use at least one source to support your discussion. APA format is required.

 

Questions

How would you respond to Mrs. M as the nurse in this situation. What might you say to her? What are some strategies to enhance communication?

 

What are your priorities in this scenario?

 

What ethical principles are relevant in this situation?

 

What resources can you use if the medical provider will not listen to Mrs. M?

 

Suppose Mrs. M withdrawals life support on her husband and he is terminally weaned from mechanical ventilation. What action would you take as the nurse? What nursing interventions might you use to support the patient and wife?

 

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