I was working day shift in the cardiac intensive care unit, and one of my patients was receiving mechanical ventilation for decompensated heart failure. By midmorning, when the medical team arrived for bedside rounds, a spontaneous awakening trial was occurring. The patient was responding well: drowsy but cooperative and answering yes-or-no questions appropriately. That morning on rounds, the medical team began to consider the patient’s eligibility for a left ventricular assist device or a heart transplant. One of the team members was assigned to reach out to the family to discuss whether they were interested in pursuing these advanced therapies. The team’s discussion was about to move to another topic when I suggested that we directly involve the patient along with the family in that discussion. I will never forget the puzzled looks that greeted my suggestion. However, as I went on to explain the patient’s current sedation level...
Advocacy for the Patient’s Voice
KNIPPA
Sara Knippa, MS, RN, ACCNS-AG, CCRN, PCCN, is the content advisor of the column. Sara is a clinical nurse specialist/educator in the cardiac intensive care unit at University of Colorado Hospital, Aurora, Colorado. She welcomes feedback from readers and practice questions from potential contributors at sara. [email protected]. Sara wrote the introduction and adult CCRN review questions 4 and 5.
MAKIC
Mary Beth Flynn Makic, PhD, RN, CCNS, CCRN-K, is an associate professor at the University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, Colorado. Mary Beth wrote adult CCRN review question 1.
COHU
Emily Cohu, BSN, RN, CCRN, is the sepsis coordinator at St. Mary’s Medical Center, Grand Junction, Colorado. Emily wrote adult CCRN review questions 2 and 3.
RADER
Cheryl Rader, BSN, RN, CCRN-CSC, is a staff nurse III in the cardiovascular intensive care unit at Saint Luke’s Hospital, Kansas City, Missouri. Cheryl wrote the Cardiac Surgery Certification review questions.
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