Patients with dementia have difficulty communicating their needs and wishes to family members and medical staff. One important medical question is whether or not these patients should be fed using artificial nutrition or hydration (ANH) (Bryon, De Casterle, & Gastmans, 2012). Some people say that with-holding food and nutrients is inhuman and that is why it can sometimes weigh heavily on the minds of nurses who care for these patients.
Discussion
In a study that was done to see what experiences nurses went through, Pasmen et al. stated (as cited in Bryon et al., 2012) that the physician is the one who ultimately has the last say in whether or not patients will receive ANH. The physician meets with the patient’s family and depending on the physician, the patients nurse as well.
Patients and their nurses’ develop a special bond that grow from the time they meet throughout their decline which make them aim to continue giving great patient care (Bryon et al., 2012). Nurses are the primary caregivers and see what the patients are going through day-to-day. “In addition, nurses were affected by persistent signals from patients – the refusal of food, defensive behavior, and apathy” (Bryon et al., 2012, p. 288). Just because a patient has dementia, does not mean they don’t know what’s going on all the time.
Conclusion
Part of our job as nurses is to advocate for our patients, not just care for them medically. By not including the nurse in this life altering decision, you are cheating the patient’s family of pertinent medical information that the physician is not always able to interpret the same way as the patient’s nurse is. For this reason, I feel doctors should always include the primary nurse when discussing whether or not to administer ANH.
References
- Bryon, E., Dierckx De Casterle, B., & Gastmans, C. (2012). “Because we see them naked” – Nurses’ experiences in caring for hospitalized patients with dementia: considering artificial nutrition or hydration (ANH). Bioethics, 26(6), 285-295.
