In this case study you will meet Tom, a 55 year old man who has advanced lung cancer and multiple metastases. To start you need to watch Tom's story. Tom's story Tom's Story Things you need to know......

In this case study you will meet Tom, a 55 year old man who has advanced lung cancer and multiple metastases. To start you need to watch Tom's story.
Tom's story
Tom's Story
Things you need to know...
After the commencement of the morphine/midazolam syringe driver to which Tom consented, Tom's daughter Carina arrived at the hospital. Carina tells you that she has power of attorney for her father and she wants the morphine stopped and changed to 'something better'. She explains she wants 'everything done to save her father'. Jimmy denies the power of attorney claim and states that his mother Cec (ie Tom's wife) is Tom's enduring guardian and he thinks his father did an "advanced care paper, but he is not sure, but that would override the guardian thing anyway".
Carina's arrival and comments are causing obvious distress to the rest of Tom's family, who are aware of Tom's wishes and are supportive of the palliative approach currently being undertaken, however they are concerned about Tom's increasing agitation and the fact he is not longer drinking or eating.
While reviewing the progress notes, you also note an entry from Tom's last admission, the page is tagged with a red dot and a medical registrar has written "Following discussion with team - NFR, not for CPR, not for ICU admission". The entry is signed and dated.
You are the Registered Nurse caring for Tom, you will need to process the information provided to:
identify the issues
establish goals

select a course of action