Scenario #1: A 49-year-old woman with advanced stage cancer has been admitted to the emergency room with cardiac arrest. Her husband and one of her children accompanied the ambulance.

As a primarily ER and ICU nurse, this is a familiar scene. When dealing with the dying patient, the last part of their healthcare can be difficult for the family as well as the provider. In this scenario a terminally ill patient arrives in the ED in active cardiac arrest, with family at
bedside. Having the patient’s family, primarily the husband, available allows the medical professional the ability to assess the patient’s wishes for end of life care. It is our responsibility to assist the family in this decision (Taylor & Johnson, 2011).

Some questions that should be addressed to the husband: Does your wife have a DNR (do not resuscitate) order? What events leadup to the patient’s current condition? Who found the patient unresponsive, if alone, and what time did this occur? When was the last time you saw your wife responsive and tell me about today? Was there anything unusual or had she had any new complaints? What type of cancer was she diagnosed with? Does the patient have a DNR or living

will? Do you want to continue CPR? Would you like for our spiritual team to accompany you in

ER?

Health assessment questions: Does the patient have a pulse? What is the EKG Rhythm? What

treatments were given in the ambulance? Does the patient have any signs of trauma? What is the

patient’s GCS? Vitals? Continue ACLS protocol if patient is in cardiac arrest.

These types of emergencies can be less stressful but if handled correctly by ER staff and

providers, can be much less traumatic for the family. As a provider it is our duty to provide the

patient’s family with needed information on treatments available for the patient.