Reference no: EM133639035

Assignment:

Jen was a highly skilled and knowledgeable critical-care nurse with 25 years of experience in the ICU. Sally was a 76-year-old women suffering from an incurable brain tumor. Informed opinion was that Sally would likely die within two weeks.

With Sally's consent, a DNR order has been placed on her chart. This meant that Sally would not be resuscitated should she experience cardiac arrest.

One afternoon, while Jen was working in the ICU, Sally grabbed her arm. Sally was partially conscious and began mumbling, "I don't want to die. Please don't let me die." Following this brief period of partial lucidity, Sally lapsed again into unconsciousness after which point she quickly began to arrest. Instinctively, Jen stated to call for help in resuscitating Sally, but pulled back when she remembered the DNR order. She let the arrest take its course and Sally quickly died. Jen was very uneasy about what she had done, but came to terms with her decision for the following reasons. (1) Resuscitation was not in Sally's best interests; (2) A valid DNR order had been issued; and (3) Despite her (questionable) mumbling, Sally had earlier agreed that CPR would not be in her best interest.

Questions:

1. Was Jen right in dismissing Sally's mumbling?

2. Should we always err on the side of caution in cases such as these?

3. Should we always resuscitate if there is any question about the patient's continued consent on a DNR order, even if resuscitation continues to be futile?