Chapter 43, Problem 1RP

Summary Introduction

To discuss:

How and why would the nurse respond to this situation.

Case summary:

Ms. A is a 49-year-old female patient who is an attorney and recently suffered from a major cerebral hemorrhage. As a lawyer, she had an advanced directive prepared that states that she should not give life-support when she is in comatose. According to the physicians and nurses, there is no sign of improvement in the patient. On the contrary, one neurosurgeon suggests that there are some signs of improvement in the patient. The patient’s family arrives and has a two-point of discussion.

Explanation of Solution

As a student nurse, she responds to the situations like talking with the social worker that the patient is already stated that she do not want life support when she is in comatose in her advance directive. The student nurse asks the social worker that why the patient directive was not followed and she personally believes that the patient’s directive should be followed.

Summary Introduction

To discuss:

The factors that affect the student nurse’s response and explain the factors with possible effect.

Case summary:

Ms. A is a 49-year-old female patient who is an attorney and recently suffered from a major cerebral hemorrhage. As a lawyer, she had an advanced directive prepared that states that she should not give life-support when she is in comatose. According to the physicians and nurses, there is no sign of improvement in the patient. On the contrary, one neurosurgeon suggests that there are some signs of improvement in the patient. The patient’s family arrives and has a two-point of discussion.

Explanation of Solution

The student nurse asks the social worker, why the patient’s directive is not implied when it is stated in the patient’s advanced directive. The social worker explains that the directive may imply ethical issues regarding the removal of life-support from the patient, when one neurosurgeon implies an improvement of the patient in comatose.

Summary Introduction

To discuss:

Whether the criteria of the student nurse is used to evaluate successful outcome.

Case summary:

Ms. A is a 49-year-old female patient who is an attorney and recently suffered from a major cerebral hemorrhage. As a lawyer, she had an advanced directive prepared that states that she should not give life-support when she is in comatose. According to the physicians and nurses, there is no sign of improvement in the patient. On the contrary, one neurosurgeon suggests that there are some signs of improvement in the patient. The patient’s family arrives and has a two-point of discussion.

Explanation of Solution

The successful outcome of withdrawal of life support by the student nurse is a critical to assess, as there are ethical issues regarding the comatose patient. Though her directive may reveal that life support should be withdrawn, but the statement of the neurosurgeon on improvement in the patient gives a little hope of recovery.

Summary Introduction

To discuss:

The knowledge, skills, and attitudes do you need to develop to continuously improve quality and safety when caring for child patients like Ms. A.

Case summary:

Ms. A is a 49-year-old female patient who is an attorney and recently suffered from a major cerebral hemorrhage. As a lawyer, she had an advanced directive prepared that states that she should not give life-support when she is in comatose. According to the physicians and nurses, there is no sign of improvement in the patient. On the contrary, one neurosurgeon suggests that there are some signs of improvement in the patient. The patient’s family arrives and has a two-point of discussion.

Explanation of Solution

• The advance directive should have more explanation for the comatose patient.
• The ethical and legal issues should be based on the logical explanations.
• The attorney must have the right to implement further treatment if there are any chances of improvement in the patient.

Summary Introduction

To discuss:

If the professional integrity is affirmed.

Case summary:

Ms. A is a 49-year-old female patient who is an attorney and recently suffered from a major cerebral hemorrhage. As a lawyer, she had an advanced directive prepared that states that she should not give life-support when she is in comatose. According to the physicians and nurses, there is no sign of improvement in the patient. On the contrary, one neurosurgeon suggests that there are some signs of improvement in the patient. The patient’s family arrives and has a two-point of discussion.

Explanation of Solution

The professional integrity of the student nurse is of course affirmed, as the student nurse did not take any actions regarding to the will of the patient or go against the neurosurgeon’s decision. The student nurse is getting more learned by expressing her suggestion to the social worker.