eting advance directives can be problematic at times, as when information is lacking, or when a strict reading of the document does not seem to make sense. For example, the advance directive may suggest one course of care, while the physician and/or family believe the patient would in fact have wanted something else. No advance directive can anticipate every situation that could possibly arise. Emergency circumstances can be another barrier to the implementation of advance directives. The emergency room physician treating an accident victim is not really in a position to halt things immediately when a nurse, looking through the patient's wallet for people to contact, finds a living will card. Nurses can make sure everyone on the health care team knows the document exists, beginning with the physician. Place it in a conspicuous position on the patient's chart and label the chart, if necessary. Nurses in the outpatient setting can educate patients to ask their physicians to make their advance directive part of their medical record, they should keep a copy where it can be found easily and to communicate their wishes clearly to their family and physician and be sure they are understood. Providing psychosocial support for patient and family has always been an essential part of medical practice. Nurses may well be trusted in large part because they are presumed to act in defense of their patients lives. Nurses give great importance to the psychosocial health of their patients. It is so imperative to be sure and comforted with the idea that a loved one is being taken care of. However, it is when that reassurance is broken with the harsh truth that one's rights have been abused that "the people who help people" are no better than an abuser of one's spirit, trust, and hope, as well....
