Kaiser Permanente, Northern California
Caritas in ActionHow Caring Science informs and inspires KP caregivers and affirms our commitment to provide our
patients and their families exceptional care
Caritas Consortium 2013
Respecting Patient/Family Choice through Authentic Presence
Intent to Contribute Statement:It was a Friday, typically my day off. I was asked to reassess one of our home health patients that had a
history of laryngeal CA, late effects of radiation treatment and a more recent CVA. When I arrived at the
house, Mr. L was sitting in his recliner and also present were his paid attendant and his two daughters. I
listened to their concerns about the patient just not being himself. I took his vitals - his respirations were up,
otherwise everything else was normal. It is not my area of expertise to do lung ausculation but it was clear
when I laid my hand on his chest that he was having respiratory issues. I called the physician - it was after
5pm. I called the case manager, Amy, who called 911. I called the MD who asked me my status - when I told
him that I was still in the home with the patient and family and that his respiratory status was compromised,
he immediately engaged. He spoke with the family and explained that this might be the end of Mr. L's life
and to gather the family to say goodbyes, and then he called the ED. Mr. L had expressed that he wanted to
die days before and he was struggling to accept the paramedics during this visit. However, with his family's
urging, he accepted. His oxygen saturation was 80% and he began to do better with oxygen.
Respecting Patient/Family Choice through Authentic Presence
With a team of people including myself, the nurse case manager, the ED, the physician, the
paramedics and Apria, we were able to respect the family's wishes for treatment but allow this
gentleman to stay home and not be transferred to the Hospital. He remained home with Apria
placing oxygen only within a few hours. This would not be what I would do with a family member or
myself. If I wanted to pass away, I would hope that a family member would respect that wish.
However, I listened to the family's wishes as well as the patient. I stayed until everything was in
place. I have no doubt that the choices I made in this situation were right for the family, patient and
me professionally.
… Continued
Respecting Patient/Family Choice through Authentic Presence
Inspired Contributor(s) 1 : Diane Foti Amy Rizen
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Service Area: GSAA
Medical Center: HAY
Affiliation: Continuum
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Year Shared: 2013
Venue: Caritas Consortium
Format: PowerPoint
ID #: n/a
1 Names as listed in Lotus Notes, otherwise personal e-mails indicated
Keyword TAGs: Identifier
Consortium2013-July, GSAA, Hayward, Podium, Home Health / Hospice
Team, Patients/Families
Descriptor Authentic Listening, Caritas
Consciousness, Storytelling
Respecting Patient/Family Choice through Authentic Presence