Reference no: EM133912976

Case 

Jessica Holmes is an experienced acute care nurse specialist caring for Mr. Sweitzer, a 61-year-old man with metastatic cancer of the bone. Admitted for an above-the-knee (AK) amputation, Mr. Sweitzer developed respiratory distress immediately after his surgery. He was resuscitated successfully, but he now suffers organic brain damage and continued confusion. This once-active patient now has limited mobility and is in considerable pain from the amputation. He also seems frightened by his confusion. At times, he cries and tells Mrs. Holmes that he would rather die than live as he is living now. At other times, he cooperates with maintenance of the ventilator and acts as if he wants to live. The mental change and ambivalence Mr. Sweitzer experiences worries his family members. They visit him often but believe that his confusion is a temporary condition and that he will soon recover and return home. They do not seem to be aware of the brain damage that he suffered after surgery. Several days after his surgery, Mrs. Holmes observes that Mr. Sweitzer has developed an intermittent pattern of Cheyne-Stokes respirations. In discussing Mr. Sweitzer's condition with the physician, she learns that the physician wants the patient to be resuscitated if he develops cardiopulmonary arrest, despite the fact that Mr. Sweitzer has indicated otherwise. Because the family members do not really understand Mr. Sweitzer's condition, they also want everything done for their loved one. Mrs. Holmes thinks that it would be cruel to resuscitate this particular patient. What should she do?

If Mr. Sweitzer were your patient, which actions would you take to respect his wishes? Why?