Dealing with Difficult Surrogates
It is difficult to count the number of times house staff have paged me frantically to say that a moribund patient's family continues to desire “everything done” despite pleas for comfort measures. This situation usually occurs at three in the morning and frequently involves an elderly patient who has been transferred from a skilled nursing facility to the hospital for recurring decompensations. There is rarely evidence in the chart of any discussion regarding end-of-life care. A phone call to the relatives of the patient invariably yields the reply, “We want everything done.”
KeywordsIntensive Care Unit Healthcare Provider Communication Skill American Thoracic Society Skilled Nursing Facility
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