When caring isn't enough

The patient met three of the expected outcomes while receiving hemodialysis. Soon after, she became an ethical dilemma and challenge for the nephrology nurses. The inconsistent telephone communications left us feeling helpless. The fourth outcome seemed to be met during the final days of G.S.'s life. As nurses, we may find it difficult caring for patients who make decisions contrary to ours. Moreover, when we are not convinced these decisions are made voluntarily and willingly, and when our nursing concerns are not received or valued, the ethical dilemmas result in overwhelming cognitive and emotional frustration.