Question

Scotty Story is a 69 years old. Scotty is currently suffering from end-stage kidney failure. Scotty has been living at home with his wife of 36 years. He has been receiving dialysis for the past 2 years, three times a week. Scotty has obtained an infection in his dialysis port, and his vitals are steadily decreasing. His family is at his bedside around the clock.

9.1 What if… You are struggling with letting Scotty pass? You want the physician to do whatever is possible to help Scotty survive. How can you look past this and accept Scotty’s wishes?

9.2 What if… The physician you are dealing with gives you an order to give 1 mg of morphine every 15 minutes for pain? While assessing your patient, you count Scotty’s respirations; the count is only 5. Morphine should be held for respirations less than 12. The physician states to give the morphine, regardless of the respirations. What should you do to protect yourself and the patient?

9.3 What if… Scotty’s family decides, at the last minute, to bring Scotty back, against his wishes? What can you do to help Scotty?

Answer 1

9.1.The CKD at its last stage can be very troublesome because it not only affects a person physically but can ruin one psychologically. It can cause symptoms associated to Central nervous system They may experience discomfort in all sprt .The pain can further ruin him.Besides all this loss the family members are emotionally disturbed to see their loving one suffer.Everyone deserves the rights to have a painless end of life which has to be seen and accepted. Hence accepting Scoty's wish is highly important.

9.2.In order to protect oneself ensure the following things are done in advance like an informed consent is taken, advance directives is there,carrying orders as per physician advice and documentation to protect one legally in future.

The patient can be protected by providing oxygen support ,stopping the medication, alerting the Rapid Response Team as per the hospital's protocol.

9.3.Some of the things which can be done for Scotty at this point is to provide a palliative or hospice care.In simple a supportive care has to be given.