Problem
54-year-old female is admitted to the hospital with septic shock. She has a history of stage IV colon cancer and is receiving in-home hospice services. The patient is currently in the ICU on a ventilator and not able to make decisions for herself. The small bowel and the bladder have developed a fistula between them leading to profound sepsis (blood cultures are positive). A friend of the patient is listed as the emergency contact and the healthcare power of attorney. A copy of the healthcare power of attorney is on the chart. This friend, however, declines to participate in the patient's healthcare decisions, citing difficulties with the patient's family. The patient's sister becomes involved and insists on full medical intervention. (Dewey & Holecek, 2018, p. 117)
This scenario plays out frequently in hospitals across the United States and elsewhere. Imagine being part of the healthcare team involved in this case.
a) How would you feel? The nurses caring for this patient may feel a variety of negative emotions, including frustration, anxiety, and anger.
b) How should the healthcare team move forward with this difficult situation?
c) Discuss use of ethics committees and what the next steps should be.