Assignment: Case Study To Consider

April 5, 2022
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Assignment: Case Study To Consider

Assignment: Case Study To Consider

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Ann and Michael have been married for 55 years. Ann is 80 years-old, and suffers from lung cancer and advanced Alzheimer’s disease. She currently resides in a nursing home, and often does not recognize Michael when he visits. Last night she was admitted to the hospital with difficulty breathing. Today, you are the nurse caring for Ann, and her physician is suggesting surgery to remove part of her lung to potentially slow the progression of her cancer. Michael is feeling unsure about this course of treatment, and asks for your advice and guidance.

How would you respond to Michael and serve as advocate for your patient?

Option #2 – Share a Related Experience

Share with your classmates a time when you cared for a patient at the end of their life. This may be a time when you assisted the patient (or their support system) with decisions related to end of life care; or a time when you were present for the death of a patient.

What were your observations related to this experience? Do you believe it was a peaceful death? What went well? Can you think of anything that could have made the experience better for the patient and/or family?

Taking care of person’s advance care directives
Tell the doctor in charge as quickly as possible if the person has written documentation as part of an advance care plan, such as do not resuscitate order. 
If end-of-life care is provided at home, you’ll need special out-of-hospital order signed by doctor to ensure that emergency medical personnel respect the person’s preferences if they are summoned to the house. 
Hospice professionals can assist in determining if medical problem is part of the natural dying process or something that requires medical intervention.

 

If person’s advance care plan does not address circumstance, or if the person does not have one, you can use alternative decision-making processes to help determine the appropriate strategy for the individual.

 

Substituted judgment and best interests are two decision-making processes.

 

When you come across decisions that haven’t been addressed in person’s advance care plan or in earlier talks with them, you can take one of two ways. 
One is to put oneself in the shoes of dying person and make decisions as they would. 
Substituted judgment is the term for this. 
When possible, some experts believe that decisions should be made on substituted judgment. 
Another option, known as best interests, is to select what you, as the dying person’s agent, believe is best for them. 
Substituted judgment is occasionally used in conjunction with this.

 

The stories below exemplify these two methods.

 

The story of Joseph and Leilani

 

Leilani, Joseph’s 90-year-old mother, was in coma following massive stroke. 
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Posted in nursing by Clarissa