An emergency nurse is caring for a critically ill patient who has expressed a desire not to be resuscitated. The patient's family arrives and insists on full resuscitation measures. What is the BEST initial action for the nurse to take?
Discuss the situation with the family to reach a consensus
Review the patient's advanced directive or living will
Proceed with full resuscitation measures as requested by the family
Immediately involve the hospital's ethics committee
The correct answer is to review the patient's advanced directive or living will. This is the best initial action because it prioritizes the patient's documented wishes and legal rights. Advanced directives are legal documents that outline a patient's preferences for end-of-life care, including resuscitation decisions. By reviewing this document first, the nurse ensures that the patient's autonomous decision is respected and legally protected.
While involving the ethics committee or discussing the situation with the family are important steps, they should come after confirming the patient's documented wishes. Proceeding with full resuscitation without checking for an advanced directive would be unethical and potentially illegal, as it may go against the patient's expressed desires. The nurse's primary responsibility is to advocate for the patient's rights and wishes, which is best achieved by first consulting any legal documentation of those wishes.
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