Case Study: End-of-Life Care Part 3
When Mr. and Mrs. Johnson’s children arrive at the hospital, Mrs. Johnson says she was thinking that it may not be the best thing for Mr. Johnson to continue on life support because it seems that it may only be prolonging his suffering. It took the cardiac arrest situation for her to finally realize that her husband will never recover. The family asks to speak to the healthcare team about removing Mr. Johnson from life support. The social worker, hospitalist, nurse, and respiratory therapist (RT) are available to meet with the family. They explain what to expect once Mr. Johnson is removed from life support, and that the family can arrange for it to be done whenever they want. Mrs. Johnson says she would like their pastor present. Arrangements are made to remove Mr. Johnson from the ventilator later that afternoon. Mrs. Johnson asks the nurse if she will be the one who will remove the life support. The nurse has never done this before and is uncomfortable. She says, “I will be present if you want me to be there with you.” The nurse then privately discusses the situation with the respiratory therapist. She has never removed someone from life support and is uncomfortable doing so for the first time in this situation. The RT says removing life support is part of RT training, and he has done so in a number of cases. He suggests that he remove Mr. Johnson from the ventilator while explaining what he is doing to the family, and the nurse can observe and offer support. Afterward, he and the nurse can meet and discuss the process so the nurse can learn. The hospitalist will be present when Mr. Johnson’s life support is terminated, and he can also be available to talk with the nurse and RT afterward.
Discussion Questions
- How did the team members respect each other’s roles, responsibilities, and expertise in Mr. Johnson’s case?
- Using this case, give examples of how team members worked together with each other and the Johnson family.
- The nurse in this case study demonstrated how interprofessional collaboration can help professionals maintain competence within their scope of practice. Can you think of other ways in which the various professionals could collaborate to learn from one another?
- Team members respected each other’s roles, responsibilities, and expertise in Mr. Johnson’s case by recognizing their own limitations and seeking assistance from colleagues who had the appropriate skills and experience. The nurse, who was uncomfortable with removing life support, deferred to the respiratory therapist who had training and experience in this area. This shows a recognition of the RT’s expertise and a willingness to collaborate for the benefit of the patient and family.
- Examples of how team members worked together with each other and the Johnson family include:
- The social worker, hospitalist, nurse, and respiratory therapist came together to meet with the family to discuss the decision to remove Mr. Johnson from life support. This multidisciplinary team approach ensured that the family received comprehensive information and support.
- The healthcare team explained what to expect once Mr. Johnson was removed from life support, addressing the family’s concerns and providing them with the necessary information to make an informed decision.
- The nurse and respiratory therapist collaborated on the process of removing life support. The RT took the lead due to their expertise, while the nurse offered support and observed, demonstrating teamwork and a patient-centered approach.
- The hospitalist was available to provide additional medical expertise and support during the process of removing life support and was also willing to help the nurse and RT afterward.
- Other ways in which the various professionals could collaborate to learn from one another include:
- Holding regular interdisciplinary meetings or case conferences to discuss challenging cases, share experiences, and learn from each other’s perspectives.
- Participating in ongoing training and educational opportunities together to enhance their collective knowledge and skills in end-of-life care.
- Mentoring programs where experienced healthcare professionals can guide and support their less experienced colleagues in handling difficult situations like removing life support.
- Encouraging open communication and a culture of learning within the healthcare team, where professionals feel comfortable seeking advice and feedback from their peers.
In this case, interprofessional collaboration not only ensured that Mr. Johnson received appropriate care but also created a supportive environment for healthcare professionals to learn and grow in their roles while respecting their individual scopes of practice.