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 in Mr. Johnson’s case respected each other’s roles, responsibilities, and expertise in several ways:
- The social worker, hospitalist, nurse, and respiratory therapist recognized their unique roles in providing holistic care to Mr. Johnson and his family. They each brought their specific expertise to the situation.
- The nurse and respiratory therapist had an open and honest discussion about their comfort levels and capabilities regarding removing life support. The RT acknowledged that it was within his scope of practice and offered to take on the task while providing guidance and support to the nurse.
- The hospitalist, who is overseeing Mr. Johnson’s care, ensured his presence during the process of removing life support, demonstrating his commitment to coordinating care and supporting the team members involved.
- Examples of how team members worked together with each other and the Johnson family include:
- The team came together to meet with the Johnson family and have an open conversation about the decision to remove life support. They provided information about what to expect, and the family’s wishes for the presence of their pastor were accommodated.
- The nurse and respiratory therapist collaborated on the plan for removing life support. The RT offered to take the lead in the procedure, with the nurse observing and providing support. This collaborative approach ensured the family’s needs were met while also addressing the nurse’s comfort and learning needs.
- The hospitalist, as the leader of Mr. Johnson’s care team, was available to provide support during the process and to facilitate communication among the team members and the family.
- In addition to the nurse and respiratory therapist’s collaboration in this case, there are other ways in which various professionals could collaborate to learn from one another:
- Regular interdisciplinary team meetings: Healthcare teams can hold regular meetings where team members from different disciplines come together to discuss cases, share their expertise, and learn from one another’s experiences. These meetings can foster a culture of collaboration and continuous learning.
- Training and simulation: Healthcare professionals can participate in interprofessional training and simulation exercises where they practice various clinical scenarios together. This can help build confidence, improve communication, and enhance teamwork.
- Cross-training and shadowing: Team members can engage in cross-training or shadowing experiences where they spend time in each other’s roles to gain a better understanding of the responsibilities and challenges faced by their colleagues.
- Case reviews and debriefings: After significant cases or events, team members can conduct case reviews and debriefings to reflect on what went well, what could be improved, and how they can collectively enhance patient care in the future.
Overall, interprofessional collaboration is essential for delivering high-quality care and fostering continuous learning and professional development among healthcare professionals.