The licensed practical/vocational nurse was caring for a client in a nursing home who has end-stage cancer and recently had a debilitating stroke (brain attack). On several occasions, nurses reported the client stated he wished he was dead

Question

One night the client arrested. The client was a full code. When the licensed practical/vocational nurse found him, she called a code blue. The staff took their time to respond and even longer to call "911." Which exemplifies the third step in the process of ethical decision making for this situation?
A) A client is at the end of his life and has verbalized that he wished he was dead.
B) Is a slow code acceptable when the client stated he wished he was dead, or should he have made the choice known and secured an order for "do not resuscitate," and since he did not, the nurses are bound to resuscitate quickly?
C) Facts: the client has end-stage cancer and a debilitating stroke decreasing quality of life. Hearsay: In several occasions the client has stated he wished he was dead. Rumors: The man deserves to join his wife in heaven; he has no family left. Emotional components: The nurses feel they would want to not be resuscitated if they were in the client's shoes.
D) Action A: Slow code and call "911" late into the code—client dies; nurses feel guilty because of legal/ethical obligations. Action B: Perform the code quickly and client may live—no change in quality of life; may have ability to secure a "do not resuscitate" order in future. Action C: Perform the code quickly and client may die—client ends poor quality of life.

Answer 1

Ans: B
Feedback:
After understanding the components or ethical decision making, the first step and describing the situation, the second step—Answer A, the nurse should describe the dilemma, the third step—Answer B. After this, information should be sorted, the fourth step—Answer C, options identified, the fifth step—Answer D, and a decision made, the sixth and last step. A code blue is not the time to make a decision about an ethical dilemma, so nurses must advocate for clients with their end-of-life decisions and secure the decisions before a code blue happens.