Katie L. George, DNP, RN, AG-ACNP, CCRN. Photo courtesy of Katie L. George.

Katie L. George, DNP, RN, AG-ACNP, CCRN

While attending this year’s American Association of Critical-Care Nurses National Teaching Institute meeting, AJN editor-in-chief Shawn Kennedy heard a story that she felt all nurses needed to hear as a reminder of the impact a nurse’s advocacy can have on a patient.

Critical care nurse Katie George, just a few years into her career when the events in the story took place, was caring for Ms. A., a young woman whose spinal cord had been nearly severed in a car accident.

Faced with a prognosis suggesting that Ms. A.’s quality of life would be poor and that she would have to remain on a ventilator, Ms. A.’s family made what they felt was the humane decision to have her removed from life support. But Ms. A.’s fiancé—and her nurse Katie George—were convinced that Ms. A., who seemed to be able to communicate by blinking in response to questions, should at least be given the chance to make the decision for herself.

Ms. A. was suffering from locked-in syndrome, a condition in which the patient is conscious and eye movement is functional despite full body paralysis. Giving her a chance to decide her own fate would require finding a way to legally validate Ms. A.’s mental capacity, although her physicians felt that this might not be possible.

AJN interviewed George about her experience working through a situation that embodied what she calls the “gray area of nursing”—being in a morally uncertain position, unsure of one’s role—to ultimately help Ms. A. decide her own fate:

[George] reached out to a colleague in palliative care, who referred her to a speech pathologist. Over the phone, the pathologist confirmed that Ms. A.’s capacity could, in fact, be legally validated through the blinking of her eyes.

“At that point I went to the attending and the resident and said, ‘Here are the calls I’ve made; we can prove her capacity by doing this,’” said George. “They weren’t happy that I had persisted after they’d said no, but they were receptive.”

From there, the situation unfolded in a way no one expected—and affirmed George’s gut instinct to stand up for her patient, despite facing resistance about this course of action from her colleagues.

For the full story, read this month’s Profiles article, “Speaking Up to Save a Life.”