Reference no: EM133242614

A 76 year old man was admitted to the hospital with metastatic cancer from his lungs to his liver, GI system and bones. The chemotherapy and oral narcotics he was on had little effect and he was unable to care for himself any longer resulting in his admission. The health care team decided that chemotherapy was no longer useful and that he be kept comfortable with medication. The facility standard of care for bedridden patients required they be turned every two hours from side-to-side. The patient screamed every time he was turned, because the pain was overbearing. A conference was called for the health care team to decide what was to be done. The nurse manager said it is clearly stated in the facility policy that a bedridden patient be turned every two hours to prevent skin breakdown. His primary care nurse disagreed with the nurse manager stating that causing more pain to a man that is obviously terminally ill does not help him. She also felt that the patient should have some say about his care. Another nurse who cared for the patient felt that the physician should make the decision and all nurses should follow the orders