[monocle]

The nurse's action in this situation is more a case of not violating his/her scope of practice. "Ice chips" is actually a specific diet order in the hospital. If a patient gets admitted with a diet order of "NPO", the the patient is not allowed to get anything by mouth ("nil per os") which includes ice chips and oral medications.

For the father to expect that the nurse should get his daughter ice chips when she probably had an NPO order is more a sign of his emotional distress during the situation. "I tell her I am the doctor, and I want the patient to have ice chips. I am told I am not the admitting physician and cannot give orders. She ignores my request to show me the location of the ice machine."

Though we all can identify with him in this situation, why would we have any expectation that the nurse would violated his/her scope of practice in this situation? The practice of nursing doesn't allow for writing a patient's orders.

His story is an example of the problem with the process of dying. All of us are dying. The question is when do you stop trying to extend life? Even a senior gastroenterologist could not help make that decision earlier for his daughter. No one - physician, father, family member - wants to bear that responsibility/guilt. We put that decision upon the person who is close to death, but they never really know how close they are. So what is the medical system supposed to do if a decision is never made? Continue will medical care, which is the most expensive at the end of life.