DISAGREEMENT, HEATHER A SUDDEN DEATH

DISAGREEMENT, HEATHER A SUDDEN DEATH Order Description   Discussion Board Case Studies/Questions Week 5: Communication Case Study: Disagreement Cindy is a 36 year old female with pancreatic cancer has been hospitalized for two weeks. She has been in the intensive care unit for the past 5 days. Her physical deterioration and suffering had created anguish in her husband and in the health care team. The attending physician discussed with the husband the likelihood of his wife having a cardiac and/or respiratory arrest, described the actions the team would take for a full resuscitation as well as the varying levels of resuscitation approved by the treatment setting, which included a Do Not Resuscitate option, and asked the husband to express his preference regarding resuscitation. The husband initially chose the do not resuscitate option for his wife and completed all of official paperwork to implement that decision. During the next 12 hours, the husband actively solicited from nursing and medical staff, their definitions of do-not-resuscitate. He then contacted the attending physician to rescind his decision, choosing instead to have a full resuscitation order in place. He explained his decision change as, “When I saw that the nurses and doctors did not all define resuscitation in the same way, I decided that I would not leave that in their hands. I am my wife’s husband and I will be her husband to the end.” This new decision was enacted and over the next four days, the patient showed clear signs of dying. Her husband stayed with her in the intensive care unit and witnessed the changes in his wife’s obvious suffering. Within two hours of her death, the husband told the nurse that he did not want his wife to be resuscitated. This information was immediately conveyed to the health care team and a brief discussion with the physician, husband, and nurse was convened to affirm this decision. Discussion: What were the barriers to effective communication in this case and how might they have been eliminated?   Week 6: Grief, Loss & Bereavement Case Study: Heather – A Sudden Death Heather was 24 years old. She was just beginning her second year as a 7 th grade math teacher and was to be married to her high school sweetheart in two months. Heather was driving to school when she was hit by a truck that ran a red light. She sustained multiple fractures, head injury, and extensive internal injuries. Her parents and older brother were informed on arrival at the E.R. that her chances for survival were extremely low. She was taken to the operating room but after 3 hours of surgery with uncontrollable bleeding and several resuscitation attempts, she died in the O.R. A clinical nurse specialist, who is on the rapid response team at the hospital, was called to be with the family when they arrived at the hospital. She stayed with them after they received the news of Heather’s death. Discussion: How is grief from this sudden death likely to differ from death resulting from chronic illness?