This is the final post. I have tried to use quiblo to make a quiz but after trying to register three times I am going ahead on my own.

The following are two scenarios and I would like your thoughts on each. I will put my thoughts at the end. I had intended a open question where several could post.

Scene one
     You are assisting a patient with her AM care, her daughter, also her Power of Attorney (POA), is in the room and they are talking. The patient is telling her daughter she wants to be a Do Not Resuscitate (DNR). The daughter is arguing in favor of resuscitation. You move on and finish your shift. You are off for a few days and return to work to find the patinet has had a massive decline. Conversation s are occuring with the daughter and doctors about making the mother a DNR. The daughter does not know what to do. What should you do?

Scene two
     The patient has demonstrated DNR wishes in the past but has not been consistant and has changed his mind repeatedly. The patient has five children and has never chosen a POA. The patient has now declined to the point of no longer eating, he is failing for lack of nutrition. The doctor has come to the room and spoken with three of the five children as he believes the patient needs a PEG (feeding) tube. The children are not decided and do not agree what would honor the wishes of the father. The family members have begun speaking to members of the staff that they have spent time with over the last several hospitalizations. They are seeking opinions on PEG tubes and what to do or how to change their siblings mind. What should the staff do? Who should be involved?

There are so many ethical issues that arise and I only see the options I am familiar with. I would  be interested in others views.
 Scene one: There would not have been knowledge if the staff had excused self during private family converation. If the staff had spoken with doctor or social staff when conversation occured perhaps avert issue. Speaking to the doctor after returning to work, he then could speak to family. Speaking directly to the family member. Ignore everything. These are not listed in a particlar order but if nothing was done on the day of the conversation in the room letting the doctor know would be better then nothing.

Scene two: Staff should not be involved in family matters and personal opinions need not confuse family issues. The doctor and social staff may need to meet with the family to discuss concerns and previously stated patient desires. All staff from all departments should be reporting family approaches to the nurse to report to social services.