Going home to die from critical care: a case study

Research output: Contribution to journalArticle

Abstract

Much of the activity in critical care is complex but repetitive. In order to standardize care and maintain safety, delivery of care is often directed by protocols and care bundles. This case study will reflect on an instance where care transcended the standard protocol-directed path to be more individualized, creative and compassionate.Acts like these can be unique for the practitioners involved and require an element of positive risk taking, which happened here. It will look at the decision-making, planning and risk involved in preparing fora terminally ill patient, who was inotrope and high-flow oxygen dependent, to go home to have treatment withdrawn there instead of in the hospital. This was to fulfil his wish to die at home. In unpicking the circumstances where this positive risk taking led to the desired outcome and the relationship between safety, uncertainty and risk, three themes arose. These were the journey to safe uncertainty; decision-making with uncertain outcomes; and the importance of robust human factors, particularly effective communication and inter-professional teamwork. If positive risk taking can result in enhanced outcomes for the patient, then the question of how this behaviour can be fostered and encouraged must be addressed.
Original languageEnglish
Pages (from-to)235-240
Number of pages6
JournalNursing In Critical Care
Volume24
Issue number4
DOIs
Publication statusPublished - 10 Jun 2019

Bibliographical note

This is the peer reviewed version of the following article: White, L. (2019), Going home to die from critical care: a case study. Nurs Crit Care, which has been published in final form at https://onlinelibrary.wiley.com/doi/full/10.1111/nicc.12437. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving at http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms.

Keywords

  • safe uncertainty
  • Decision-making
  • human factors
  • critical care
  • end-of-life-care
  • End-of-life care
  • Human factors
  • Critical care
  • Safe uncertainty

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