Mrs. Smith was an 85-year-old widowed female, brought to the emergency department (ED) after her at-home caretaker found her in respiratory distress. The ED doctor noted that the patient was minimally responsive to verbal stimuli, afebrile, normotensive, tachycardic to 130 bpm, and tachypneic to 30 breaths/min. A chest radiograph (CXR) revealed right lower lobe consolidation. Based on her health history, it was found that she had recently been admitted to the hospital for significant weight loss (a few months ago) and she was diagnosed with advanced bowel cancer with lung, bone, and brain metastases. While in the ED, Mrs. Smith’s respiratory function deteriorated, and she was admitted to the ICU for closer observation. Within 24 hours of being admitted to the ICU, Mrs. Smith’s condition deteriorated rapidly, and a decision was made to talk with the family of what should be done in the event of respiratory or cardiac arrest. The son, who is the first contact listed, was informed about his mother’s condition, and it was revealed that Mrs. Smith had previously stated to him that she does not want any heroic measures done in the event of cardiac arrest. The conversation with the son resulted in the decision to initiate a Do Not Resuscitate (DNR) order. The next day, the patient’s daughter arrived. The daughter mentioned that she had a distant relation with her mother and had not been in contact with the patient over the past 3 years. The daughter expressed that she wanted everything done for her mother. You are the nurse assignment to Mrs. Smith. Identify the ethical dilemma in this scenario What are the ethical principles that apply to the scenario? Use the five-step nursing process approach, how would you resolve this ethical dilemma?
Mrs. Smith was an 85-year-old widowed female, brought to the emergency department (ED) after her at-home caretaker found her in respiratory distress. The ED doctor noted that the patient was minimally responsive to verbal stimuli, afebrile, normotensive, tachycardic to 130 bpm, and tachypneic to 30 breaths/min. A chest radiograph (CXR) revealed right lower lobe consolidation. Based on her health history, it was found that she had recently been admitted to the hospital for significant weight loss (a few months ago) and she was diagnosed with advanced bowel cancer with lung, bone, and brain metastases. While in the ED, Mrs. Smith’s respiratory function deteriorated, and she was admitted to the ICU for closer observation. Within 24 hours of being admitted to the ICU, Mrs. Smith’s condition deteriorated rapidly, and a decision was made to talk with the family of what should be done in the event of respiratory or cardiac arrest. The son, who is the first contact listed, was informed about his mother’s condition, and it was revealed that Mrs. Smith had previously stated to him that she does not want any heroic measures done in the event of cardiac arrest. The conversation with the son resulted in the decision to initiate a Do Not Resuscitate (DNR) order.
The next day, the patient’s daughter arrived. The daughter mentioned that she had a distant relation with her mother and had not been in contact with the patient over the past 3 years. The daughter expressed that she wanted everything done for her mother. You are the nurse assignment to Mrs. Smith.
- Identify the ethical dilemma in this scenario
- What are the ethical principles that apply to the scenario?
- Use the five-step nursing process approach, how would you resolve this ethical dilemma?
Introduction:-
Donot resuscitate has got a lot of ethical issues with it. If the patient has signed the DNR form and asked that is it comes to terminal situations where resuscitation is needed then it should not be done like CPR, VENTILATION etc.
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