A patient with end-stage COPD who has failed multiple mechanical ventilation weaning trials communicates a...

The nurse’s best response is to explore the patient’s reasons for the request and understanding of potential consequences, as this demonstrates respect for the patient’s autonomy and dignity, as well as provides an opportunity to assess the patient’s decision-making capacity, goals of care, and preferences for end-of-life care. The nurse should also provide emotional support, education, and symptom management to the patient and family. Advocating with the care team for a withdrawal of treatment plan, encouraging the patient to continue with current medications and attempts to wean, or referring the patient’s request to the healthcare facility’s ethics committee for review are not appropriate responses, as they may undermine the patient’s right to self-determination, impose the nurse’s own values or beliefs, or delay the implementation of the patient’s wishes.

References:

AACN. (2023). CCRN (Adult) Exam Handbook. Retrieved from [CCRN Exam Handbook], p. 19.

AACN. (2023). CCRN (Adult) Exam Blueprint. Retrieved from [CCRN Exam Blueprint], p. 2.

AACN. (2020). Practice Recommendations for End-of-Life Care in the Intensive Care Unit. Retrieved from [Practice Recommendations], p. 14-15.

NICE. (2019). End of life care for adults: service delivery. Retrieved from [NICE Guidance], p. 4.