DNR does not mean no care.
End-of-life care is a complicated topic, especially in a neurological intensive care unit. Death is a daily part of nursing care and should be treated with respect and a definite plan of care. Unfortunately, there are still hospitals that do not have protocols to deal with this outcome. The administration of opioids and appropriate sedation can be the difference between a calm serene death or one that is fraught with dyspnea, struggling, and unhappy families. Every hospital should have palliative care and hospice planning. This case study is about a dying patient that did not receive palliative care appropriately; however, through determination and personal knowledge of death and dying, a neurosurgical nurse was able to change the way a hospital dealt with do-not-resuscitate patients. Do not resuscitate does not mean no care; it means a different kind of care that can best be achieved through end-of-life protocols and education.
Fields
Lorraine
L
Summa Health System, Akron, OH, USA. fieldsl@summa-health.org
D000368:Aged; D002985:Clinical Protocols; D003142:Communication; D016292:Procedural Sedation / Q000451:nursing; D003422:Critical Care / Q000458:organization & administration* / Q000523:psychology; D005190:Family / Q000523:psychology; D005260:Female; D006301:Health Services Needs and Demand; D006323:Heart Arrest / Q000523:psychology / Q000628:therapy; D006801:Humans; D024802:Nurse's Role / Q000523:psychology; D009723:Nurse-Patient Relations; D015279:Organizational Culture; D010166:Palliative Care / Q000458:organization & administration* / Q000523:psychology; D010344:Patient Advocacy; D010347:Patient Care Planning / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration; D011369:Professional-Patient Relations; D011788:Quality of Life / Q000523:psychology; D016414:Resuscitation Orders / Q000523:psychology; D017592:Skin Care / Q000451:nursing; D013597:Systems Analysis; D015300:Ventilator Weaning