Resuscitative Decisions in the Emergency Care Setting Position Statement-Resuscitative Decisions in the Emergency Care Setting Position Statement

Pdf Summary

Resuscitative decisions in the emergency care setting can be complex and controversial, especially when there are no advance directives (AD) specifying the patient's wishes. Ethical and legal issues, as well as family dynamics, can complicate these decisions. Barriers to providing care in accordance with the patient's wishes include the absence of an AD or a vague AD that does not provide meaningful information. Emergency care providers may also have difficulty accessing ADs, even when they are available in the patient's records. Resuscitative decisions often arise during clinical deterioration or end-of-life care, and the increasing aging population and advances in healthcare technology further magnify these issues. <br /><br />The Emergency Nurses Association (ENA) takes the position that emergency nurses should respect the patient's autonomy and collaborate with other healthcare professionals to ensure compliance with the patient's stated wishes. They advocate for advance care planning, educate patients and families on planning options, and support a patient- and family-centered care approach. The ENA also supports family presence during resuscitation if desired by the family and emphasizes the importance of emergency nurses' participation in the development and evaluation of resuscitative decision policies and protocols. It is crucial for emergency nurses to be knowledgeable about specific laws and regulations regarding ADs in their practice locations.<br /><br />Various documents and resources, such as living wills, durable power of attorney, and Physician Orders for Life-Sustaining Treatment (POLST), can be used to specify the patient's treatment wishes. Different terms, such as Do Not Resuscitate (DNR), Comfort Measures Only (CMO), and Full Code, are used to indicate the patient's treatment preferences during resuscitation. It is important for healthcare providers to consider additional criteria for decision making, such as irreversible death or evidence that resuscitation would be against the patient's wishes or futile. Crisis situations, like pandemics, may also require a different approach to resuscitative decisions.<br /><br />Implementation of structured advanced care planning and a patient- and family-centered care approach can lead to greater patient involvement and self-determination. Family presence during resuscitation is supported by the ENA and other organizations. Overall, emergency nurses play a crucial role in advocating for patients and their families regarding resuscitative decisions and ensuring that their wishes are respected and followed.

Meta Tag

resuscitative ethics

resuscitative life-sustaining

resuscitative advance directives

resuscitative living will

resuscitative power of attorney

resuscitative minor

resuscitative family-centered care

resuscitative DNR

resuscitative DNI

resuscitative DNAR

resuscitative CMO

resuscitative FC

resuscitative code

resuscitative comfort measures

resuscitative hospice

Keywords

resuscitative decisions

emergency care

advance directives

ethical issues

legal issues

family dynamics

barriers to care

aging population

healthcare technology

Emergency Nurses Association