Reference no: EM133954441

Cindy is a 36-year old female with pancreatic cancer has been hospitalized for two weeks. She has been in the intensive care unit for the past 5 days. Her physical deterioration and suffering had created anguish in her husband and in the health care team. The attending physician discussed with the husband the likelihood of his wife having a cardiac and/or respiratory arrest, described the actions the team would take for a full resuscitation as well as the varying levels of resuscitation approved by the treatment setting, which included a do-not-resuscitate option, and asked the husband to express his preferences regarding resuscitation. The husband initially chose the do-not-resuscitate status for his wife and completed all of the official paperwork to implement that decision. During the next 12 hours, the husband actively solicited from nursing and medical staff their definitions of do-not-resuscitate. He then contacted the attending physician to rescind his decision, choosing instead to have a full resuscitation order in place. He explained his decision change as, "When I saw that the nurses and doctors did not all define resuscitation in the same way, I decided that I would not leave that in their hands. I am my wife's husband and I will be her husband to the end." This new decision was enacted and over the next four days, the patient showed clear signs of dying. Her husband stayed with her in the intensive care unit and witnessed the changes in his wife's physical appearance. He began commenting on those changes and on his wife's obvious suffering. Within two hours of her death, the husband told the nurse that he did not want his wife to be resuscitated. This information was immediately conveyed to the health care team and a brief discussion with the physician, husband, and nurse was convened to affirm this decision.

Discussion Questions:

1. What were the barriers to effective communication in this case?

2. How might these barriers have been eliminated? What would have facilitated effective communication?