tailieunhanh - Báo cáo y học: " The role of teams in resolving moral distress in intensive care unit decision-making"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: The role of teams in resolving moral distress in intensive care unit decision-making. | Available online http content 7 3 217 Commentary The role of teams in resolving moral distress in intensive care unit decision-making Mary van Soeren1 and Adèle Miles2 Assistant Professor School of Nursing Atkinson Faculty of Liberal and Professional Studies York University Toronto Canada 2Pastoral Care Consultant St Thomas-Elgin General Hospital St Thomas Canada Correspondence Mary van Soeren Published online 7 March 2003 Critical Care 2003 7 217-218 DOI cc2168 This article is online at http content 7 3 217 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Conflicts arise within teams and with family members in end-of-life decision-making in critical care. This creates unnecessary discomfort for all involved including the patient. Treatment plans driven by crisis open the team up to conflict fragmented care and a lack of focus on the patient s wishes and realistic medical outcomes. Methods to resolve these issues involve planned ethical reviews and team meetings where open communication clear plans and involvement in decision-making for all stakeholders occur. In spite of available literature supporting the value of these techniques patient care teams and families continue to find themselves involved in spiraling conflict pitting one team against another placing blame on family members for not accepting decisions made by the team and creating moral conflict for interdisciplinary team members. Through a case presentation we review processes available to help resolve conflict and to improve outcome. Keywords critical care moral distress physician-nurse relationship team interaction Case Sara a 23-year-old woman was admitted to the transplant service with early-onset idiopathic pulmonary fibrosis neutropenia and anemia. Both her mother and brother were affected with the same disorder. Her mother died several years ago ventilated in the intensive care unit ICU a death Sara describes