If you gave the Nightingale pledge at this moment I’m here to inform you, we have failed in some ways as nurses. Admittedly I am new to nursing, real new. Already though I have seen something that has truly just rubbed me completely the wrong way and I can’t believe everyone before me hasn’t said much about it. If you have, the roar was not loud enough.
I walked into a patient’s room and saw two very completely opposite signs hanging over their bed. One said very clearly “
DNR” and the other just as clearly “Family wants intubation.”
My first thought was how sad the family wants that, clearly they don’t
understand what DNR means. Only
then did I found out it wasn’t the family that didn’t understand, but it was
I was told that even if the patient wants to be
DNR, but the family wants us to continue, then we
continue. I was told the family would sue us if we didn’t, so, we continued
even if it was against the patient’s wishes. What? They would be alive to sue
and the patient would be dead so we went with the option that presented the
least legal ramification. How is it possible that a person’s last and maybe
most important decision and wish are to be discarded that easily? I am positive
that it says in any medical pledges or oaths that we are to do what is best for
our patients. What could be more important?
My first duty is to my patient, but clearly hospitals and lawyers see things differently. In school, nursing ethics is pushed so hard we almost choke on it. Talk about being completely unethical, but you are ordering me to violate my patient’s wishes to keep them alive when they don’t want to be? This seems to be happening at an alarming rate as I hear of surgical procedures being done for operations that are unnecessary and only complicate and prolong suffering in the patient who didn’t want it or need it in the first place. How has this become acceptable?
As a profession we are capable of amazing things, how did we get to this point? If a patient wants to leave against medical advice even though it could harm them we allow it. If a parent refuses to bring their child to a doctor for religious reasons then we are not allowed to act without a court order. If a patient refuses a medication we don’t force them to take it. Yet, an adult who in advance gives a directive that they want followed for the course of their life we discard it because the family is unwilling to accept it?
I submit, out of all the problems America currently has with health care, this is the biggest. We have forgotten what we are here for and who we are supposed to be taking care of when they are in the hospital.