If a husband presents an advance directive to an NP for his wife with a traumatic brain injury on a vent, what should the NP do?

When faced with an advance directive provided by a husband for his wife who has a traumatic brain injury and is on a ventilator, discussing the advance directive with the husband is the most appropriate action. This is essential because advance directives are legal documents that indicate a patient's wishes regarding medical treatment when they are unable to communicate those wishes themselves.

Engaging the husband in a discussion allows the nurse practitioner to understand the details and specific wishes outlined in the directive. It also opens the door for exploring his understanding of the situation, the patient’s prognosis, and what the directive entails regarding life-sustaining treatments. This conversation is critical to ensure that the NP is fully informed of the patient's wishes and can advocate for them appropriately.

Moreover, discussing the advance directive fosters shared decision-making, which is a key component of patient care in acute settings, particularly regarding end-of-life issues. It helps the husband feel involved in the decision-making process and reinforces the care team's commitment to honoring the patient's autonomy and preferences.

Addressing the advance directive in this manner also lays a solid foundation for any subsequent actions that may be necessary, such as consulting legal counsel or an ethics committee if there are uncertainties or conflicts regarding the directive or its interpretation.