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PDF Editor FAQ

What should a nurse understand about health care proxies or a durable power of attorney for healthcare?

That patients can change their mind when in the situation and asking and confirming their wishes is good medical care.“I see that you have an advanced directive on file with us. Is there anything different that you would like us to know about your wishes today?”It’s an open ended question and implies nothing about the patient’s current medical condition.Sometimes when I ask this question, the patient will then respond with questions on prognosis and options. If the situation is dire, I inform them, which will often trigger a call to close friends and children to come for a potential last visit and farewells.

Would liberals avoid going to conservative doctors?

I don’t ask a doctor their religious or political affiliation when I go to see them. The only things I ask are the following:1) Do you agree that a doctor/patient relationship is a partnership? The doctor knowing the medicine, and the patient knowing their body and how it reacts.2) Will you respect my religious beliefs and wishes, even if they conflict with your own?3) Will you be, at all times, open and honest with me? Never leaving out treatment options or glossing over the seriousness of a health issue due to your beliefs?If that’s all good, then we’re probably going to get along well. I don’t go to my doctor to get preached to. I also don’t go to my doctor to get half-truths, or to have them omit treatment options because it goes against their religious or political beliefs.Finally, I made a Living Will via Compassionate Choices - A Federal Attack on D.C.’s Medical Aid-in-Dying Law Threatens All Such Laws]Included in that Living Will are such things as a “Letter to my Doctor” that states the following:“It is important to me to have excellent and compassionate care - to stay as healthy and active as possible over the course of my life. At the end of life, my personal values and beliefs lead me to want treatment to alleviate suffering. Most importantly, I want to ensure that if death becomes inevitable and imminent, the experience can be peaceful for me and my family.If there are measures available that may extend my life, I would like to know their chance of success, and their impact on the quality of my life. If I choose not to take those measures, I ask for your continued support.If my medical condition becomes incurable, and death the only predictable outcome, I would prefer not to suffer, but rather to die in a humane and dignified manner. I would like your reassurance that: If I am able to speak for myself, my wishes will be honored. If not, the requests from my health care representative and advance directives will be honored.You will make a referral to hospice as soon as I am eligible, should I request it.You will support me with all options for a gentle death, including providing medications that I can self-administer to help my death be as peaceful as possible.I am not requesting that you do anything unethical while I am in your care, but I hope for your reassurance that you would support my personal end-of-life care choices as listed above.I hope you will accept this statement as a fully considered decision, and an expression of my deeply-held views. If you feel you would not be able to honor such requests, please let me know now, while I am able to make choices about my care based on that knowledge. “It also has a section regarding religious and other such institutions/hospitals:“ I understand that circumstances beyond my control may cause me to be admitted to a healthcare institution whose policy is to decline to follow Advance Directive instructions that conflict with certain religious or moral teaching.If I am an inpatient in such a religious-affiliated healthcare institution when this Advance Directive comes into effect, I direct that my consent to admission shall not constitute implied consent to procedures or courses of treatment mandated by ethical, religious or other policies of the institution, if those procedures or courses of treatment conflict with this Advance Directive.Furthermore, I direct that if the healthcare institution in which I am a patient declines to follow my wishes as set out in this Advance Directive, I am to be transferred in a timely manner to a hospital, nursing home, or other institution which will agree to honor the instructions set forth in this Advance Directive.I hereby incorporate this provision into my durable power of attorney for health care, living will, and any other previously executed advance directive for health care decisions.”As you can see, I take my healthcare options very seriously. They are mine to make, and I should be free to make them. I do not want my doctor to violate their own ethics (or the law), but if their ethical stance prevents them from following my wishes, then they need to transfer my care to someone who will be able to better follow my wishes, if possible and legal.A doctor-patient relationship is a partnership. I must do my part, as a patient, to listen to my doctor and follow their instructions to the best of my ability. By that same token, the doctor must listen to me and to how I report my symptoms and side-effects, and my limitations with regard to what I can and cannot do. I will not have a doctor that tells me that it is “My way or the highway”. If that is my choice, I will find a different doctor (unless there is a VERY good reason for that position - such as I will die without following their specific instructions).

If you could warn the world of one thing, what would it be?

I have a list that isn’t complete:Donald Trump is mentally ill and should not be president. This one should be self-explanatory.US military personnel are being used to both prop up multi-national corporations and are used as medical guinea pigs for experimental drugs and vaccines. Most of the current missions seem to be more about protecting the oil of companies like Exxon/Mobile and Shell (along with the exploitation of other countries resources)and less about serving the country as a whole.Climate change is real and is here now not a hundred years from now. If you are alive today, you are being affected by it whether you realize it or not. Climate refugees will be the biggest transfer of humans on the planet to areas with more land and resources for those who are displaced. Nearly the entire country of Bangladesh, for instance, could be underwater in just a few decades if not sooner. Those people will be trying to go somewhere else that isn’t flooded.You have a 37% chance of becoming disabled before you turn 65. Most are unprepared for this possible outcome, but it happens frequently.You should have some documents put in place as soon as you turn 18. These include: a) Durable Power of attorney for healthcare, mental healthcare, and finances should you become unable to take care of them yourself if you are in a major accident. Each can be the same or different people. b) An advanced directive for healthcare in which you can determine if you want every heroic measure taken to keep you alive or if you just want comfort care depending on what is wrong with you. c) a last will and testament so your heirs know how you want your possessions distributed as well as last wishes for burial, cremation, or donation to science or organ donation. Also if you want a funeral or celebration of life or nothing at all. d) other options can be having a revocable trust(put all of your larger monetary items in it such as homes, cars, bank accounts, 401k’s, Roth or traditional IRA’s and any other stock or bond portfolios you may have along with any other real property you may own(contact an attorney to set one up)) e) having a long term care policy, life insurance policy, and a 529 account for your children's education are other options.Planning out your time in retirement is as important as planning out your other financial aspects because time slippage occurs too easily if you don’t have goals and a timeline in which to accomplish them before its no longer viable.The longer you are retired the more you are going to have to cut back on expenses as your income is mostly fixed and COLA doesn’t even begin to cover the actual inflation you will experience.That is a start at least. I’ll likely add more as I think of them.

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