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Keywords:

  • collaborative effort;
  • unique situation;
  • dying patient;
  • dying wish;
  • multidisciplinary team;
  • plan of care

Poster Presentation

  1. Top of page
  2. Poster Presentation

Background

In 2012, a large metropolitan hospital continues to support nurses to meet patient and family goals and significantly make a difference in their lives. This was a unique situation where nurses, physicians, managers, and hospital units collaborated to meet the wish of a dying patient to hold his unborn child.

Case

The intensive care unit had a cancer patient with complications that left him dependent on a large amount of high-flow oxygen. If the oxygen was removed for any period of time, his oxygen saturation would quickly drop to a level not compatible with life. The patient, family, doctors, and nurses looked into all the conventional and nonconventional methods of treatment and could not find any way to reverse this life-ending complication. A plan of care was reviewed concerning measures to prolong his life. He declined to be placed on a ventilator, and he understood that he would die in a short period of time (5-7 days estimated by his physician). Nurse A was assigned to this patient. She was able to develop a bond with him and influenced this collaborative effort.

The patient's wife was 38 weeks pregnant, with plans to deliver their third infant at another hospital closer to home. Nurse A asked if we could meet her patient's needs and dying wish. On the day of delivery, nurse B volunteered for this assignment. A room was chosen to provide adequate space for two beds, infant warmer, cardiac and fetal monitors, and work areas for two nurses. Ongoing changes in the plan of care continued as the day progressed. The wife's preference for a female physician was coordinated. Both beds were placed side by side to enable husband to participate in the labor process. Anesthesia and nursing coordinated to provide adequate comfort level during advanced dilatation. Nursing provided many words of encouragement as the second stage of labor progressed to the delivery of an infant girl.

Conclusion

After delivery, the infant was placed in the patient's arms. Nurse A was on duty the day the patient passed away holding his daughter with his wife at his side. Through a collaborative multidisciplinary team effort, members can actively seek ways to improve the care they offer to each patient and to utilize each other's skills to increase quality of care.