An unconscious patient is brought to the emergency department with severe head trauma. The patient's spouse arrives and presents a valid advance directive stating the patient's wish to refuse life-sustaining treatment. What is the BEST course of action for the emergency nurse?
Initiate life-sustaining treatment immediately
Wait for physician orders before taking any action
Contact the hospital ethics committee for guidance
Honor the advance directive and withhold life-sustaining treatment
The correct answer is to honor the patient's advance directive and withhold life-sustaining treatment. Advance directives are legal documents that express a person's wishes for end-of-life care when they are unable to communicate. As healthcare professionals, we are ethically and legally obligated to respect these directives when they are valid and applicable to the current situation.
While it may be tempting to initiate treatment immediately or wait for physician orders, doing so would violate the patient's expressed wishes and autonomy. Contacting the ethics committee, while sometimes appropriate in complex cases, is not the best first step when a clear, valid advance directive is present.
It's important to note that emergency nurses should still provide comfort care and ensure the patient's dignity is maintained throughout the process. Communication with the spouse and other family members about the patient's wishes and the care plan is also crucial.
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