Reading Skills for Healthcare Workers

Lily is a nurse assistant in a hospital. Today she meets a new patient, Mr. Garcia, and checks his chart to discover that Mr. Garcia has late stage liver cancer. Lily sees on the chart that he has an advance directive on file with the hospital. An advance directive is a form that tells the hospital staff what types of care Mr. Garcia wants if he is so ill that he is unable to tell the staff himself. Under the Patient Self-Determination Act (PSDA), health care facilities must ask patients and residents whether they have an advance directive and must give them information about their rights under state law.

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The advance directive is a legal document. Lily reads on the form that Mr. Garcia would not like to be put on life support if he cannot breathe on his own in the future, but he would like to be kept as comfortable as possible in his final days. The form was signed by Mr. Garcia last year, when he was healthier.

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Mr. Garcia’s daughter Sonia visits in the afternoon and talks to Lily outside Mr. Garcia’s room about how he is doing today and about whether Lily knows about Mr. Garcia’s advance directive. Lily assures Sonia that the hospital staff will follow Mr. Garcia’s wishes for his health care and reminds her that if she has any questions about what care her father will receive when he is dying, she is welcome to ask the nursing supervisor or Mr. Garcia’s doctor.

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Sonia is glad her father took the time to put his preferences in place, and she supports her father’s wishes. When Mr. Garcia signed his form last year, he shared the document and his wishes with his children so that they would know what he wanted for his end-of-life care. Lily is glad to know that Mr. Garcia made the advance directive before he became very ill and then shared it with his family.