Ben was a 55 year old man admitted to an intensive care unit following a traumatic brain injury; despite the best efforts of the medical team, Ben had not responded to treatment. A decision was made by the medical team, after a brainstem test, to withdraw treatment and turn off his ventilator. According to the Human Rights Act, 1998, if treatment given is shown to be futile and not in the best interest of the patient, the medical team are not obliged to continue with treatment. (British Medical Association, 2007) (BMA) Ben’s only relative, Liz, his sibling, was kept fully informed throughout. She was fully aware of the reasons for the brain stem testing and possible outcome of a negative result. Liz had refused consent for organ donation, if the ventilator was to be turned off. Following test results a meeting was scheduled with the inter-professional team and Liz, to include: the consultant, Ben’s nurse and myself.
Over the last few days I had spent a significant amount of time with Liz, attending the meeting made me feel apprehensive, as I was unsure of Liz’s reaction, and what my role as Bens nurse should be. Henderson (1966) defines the nurse’s role as assisting individuals, sick or well, in activities contributing to health and recovery or death. As Bens nurse, I had a duty of care to act as his advocate; this role as stated in the NMC,b (2009) involves promoting and protecting the people in my care. If I felt Liz was becoming confused with medical jargon, it would be my role to intervene and simplify or clarify matters, give more information if needed. Working within an inter-professional team gave me a sense of group identify and efficiency, not experienced as an individual. I was confident that, if required, I could contribute my experience and knowledge to the meeting, whilst mindful of my role and limitations as a student. (NMC, 2009) Team working is only effective if we work collaboratively, and get an understanding of the different roles and levels of expertise within each profession. (Meads and Ashcroft, 2005)
Good use was made of Ben’s medical notes throughout the meeting; had these notes not been rigorously maintained, mal practice could be sited, especially in the case of ‘organ donation’. This was ultimately an invaluable experience for myself in dealing with the relatives of patients with a terminal illness. This in my opinion is learned through ‘hands on’ experience, and not easily learned through text books or lectures. Another area where my placement was invaluable, was being party to difficulty for the team of giving bad news to the relative in a particularly situation such as Ben’s. Regional Guidelines and protocols aim to summarise and standardise the approach in which bad news is broken. The guidelines contain key communication techniques which are structured and organised in such a way that will guide medical and other healthcare professionals to facilitate the flow of information to patients, clients, families and carers. (Department of Health, Social Services & Public Safety, DHSSPS, 2003; Buckman, 1992,...