Patient Decision

I work in the emergency room, and we have a variety of times when patients come in unconscious they do not have a say in their medical care. One example when a patient had a voice in their care is with a patient who had gone septic. This patient was accompanied by their daughter, and the patient’s blood pressure was rapidly dropping. We had this patient in the ER as an ICU hold because the ICU was full. The ICU doctor came to the bedside in the trauma room and discussed intubation with the patient and his family. The daughter and the patient were really against the idea of intubation. The patient was put under pressers, but the blood pressure was rapidly declining, and the patient started not to be able to compensate. Eventually, the patient had to be emergently intubated, and we had to call the house supervisor to get the patient to the ICU as fast as possible.

Consequences

            They were considering the patient’s wishes and desires in this situation may have negatively impacted the patient’s outcomes. The patient was transferred to the ICU post-intubation, so I do not know what the result was. Had the patient been intubated earlier, they may have had a more positive outcome or extubated sooner than they were. It is impossible to know precisely what would have been different had he been intubated sooner than he was. It is vital to give the patient the right to make their own decisions, but it is the medical staff's job to ensure the patient has all the needed information to make a decision (Olejarczyk & Young, 2022).

Aide

            I would use the decision aid for this individual, specifically for the daughter. Since the patient is intubated in the ICU, there are a variety of decisions and questions that the family members will most likely have. The aide is titled “Understanding the Options: Planning Care for Critically Ill Patients in the intensive care Unit. This aide addresses treatment options in the ICU and discusses the need for family members to make decisions (Kryworuchko, 2015). In general, this aid is helpful because when a patient is in the ICU, it is complex for a family member to know their role (Alsharari, 2019). The family has much more say in the healthcare of an intubated patient due to the patient’s inability to make decisions (Kryworuchko, 2015).

Using this Model in Everyday Life

            I will use this model in my work in the ER. We have many patients that end up getting intubated and go up to the ICU. It would be necessary to educate the patient and their family members about what is entailed in intubation and the ICU. Family members play a vital role in the treatment of an intubated patient, and this aide can educate the family on what that role is (Alsharari, 2019).

Resources

Alsharari A. F. (2019). The needs of family members of patients admitted to the intensive care unit. Patient preference and adherence, 13, 465–473. https://doi.org/10.2147/PPA.S197769

Kryworuchko, J. (2015). Ottawa Hospital Research Institute. Understanding the Options: Planning Care for Critically Ill Patients in intensive care Unit. Retrieved January 31, 2023, from https://decisionaid.ohri.ca/Azsumm.php?ID=1388

Olejarczyk, J. P., & Young, M. (2022, November 28). Patients' Rights and Ethics. National Library of Medicine. Retrieved January 31, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK538279/