David demonstrated advocacy when caring for a patient who expressed not wanting to be intubated. This patient had required intubation and was able to come off the ventilator. Throughout the day concern was expressed that the patient was declining. The patient was able to state that she would not want to be intubated again but no LET orders were present.
On the other hand, the family and decision-makers were of the mindset to do all interventions necessary. David recognized that if the situation escalated and the patient declined to no longer be decisional, her wishes may not be upheld. David worked throughout the day to educate the family, talked with the physician, and ensure that the patient's wishes were upheld. Because of his work LET orders were obtained and reflected what the patient had asked.
This patient did pass away the following shift but was able to do so peacefully surrounded by multiple family members and was comfortable. Had David not worked so hard, it's possible the patient would have been re-intubated, and the direction of care would have taken a much different path. David recognized he needed to ensure the patient's wishes were upheld and supported the family at the same time to make sure they were comfortable as well.