The decision to terminally wean a critically ill patient - Article Example

Nursing, as well as the other aspects of the medical profession, is one of the most demanding of tasks, requiring as much skill as an admirable character. Nursing care is directed towards the essential and comprehensive needs of the patient, as well as the needs of their families during the entire course of the medical treatment. This is especially important during the difficult times of passing away of the patient, where the role of the nurse is to relieve the symptoms and suffering associated with the process of dying, as well as the emotional burden that the family is left to cope with.

"The nurse should provide interventions to relieve pain and other symptoms in the dying patient even when those interventions entail risk of hastening death. However, nurses may not act with the sole intent of ending a patient's life even though such action may be motivated to by compassion, respect for patient autonomy and quality of life considerations"1. First, it is important to understand that the terminally ill patients, no matter of their illness, are divided into 2 main groups. The first group is the patients capable of communicating with the environment and therefore are capable to make conscious decisions about their future treatment and medical care.

The second are those that are unconscious, in particular those who are on life support systems. Both conscious and unconscious patients receive pain control medications to ease their suffering. Pain control is one of the basic treatments given to terminally ill patients. It relieves the physical, as well as the emotional stress of the family. According to latest protocols administrating the pain control medications begins with you examining patients' or the families' attitude toward pain control, and then toward a specific preferred assessment tool.

You also need to perform a comprehensive pain assessment by reviewing pathophysiologic or psychological causes of pain. Don't forget to asses the patients' response after an hour of administrating the analgesic. Also, immediately inform the doctor when the pain control regiment has reached the maximum limit, or there are sighs of adverse reactions. It is also important to explain to the patient (if possible) and his family that everyone has individual pain response to illness, and that pain control is important to proper medical care.

Never to forget to review the pain medications' side effects. "Withdrawing ongoing life support is a dreaded but necessary therapeutic maneuver when life-supporting devices have become hindrances rather than benefits"2. Pain control medications are still administered to ease the passing of the patient. There are 2 methods of removal: terminal weaning in which the endotracheal tube is left in place as ventilation support is slowly withdrawn, and terminal extubation in which the endotracheal tube is abruptly removed and the patient is suddenly without ventilation support.

Most doctors and medical personnel believe that "terminal weaning is the most desirable mode for both ergonomic and physiologic reasons. The continued