Patient Decisions: When You’re Just Not Up to Making the Call
By Karen Roush, MS, RN, FNP, clinical managing editor
Photo by the author
For most patients and in most clinical situations, decision making is and should be a shared process between the patient and the clinician (and often the family). But there are some cases when we, expert clinicians versed in scientific and experiential knowledge, need to make a decision for the patient—not out of some paternalistic idea of our authority or superiority, but because the patient really wants or needs us to take on that burden.
I was six months pregnant with my second child. The pregnancy had gone smoothly, which was a blessing after having delivered my first child 10 weeks premature following two weeks spent in a tertiary care center. That pregnancy had been problematic from the beginning—early bleeding, and then a hemorrhage at five months, at which time they’d diagnosed me with placenta previa. It was one of those pregnancies where you were thankful for each additional day that brought you closer to the nine-month mark.
But this time, everything was going smoothly—no bleeding or cramps, an active baby that ultrasounds confirmed was growing well . . . until one morning in February, when I started with cramps that progressed to pain and a lot of pressure. An hour later, I was in the labor and delivery […]
