Just Wondering

I confess I was eavesdropping--but the conversation was so near and so compelling, I couldn't help but listen. I was meeting with a colleague in her office, when one of her staff came to the door with a problem. Holding two patient files, one in each hand, the staff member, a home health intake nurse, said, "Okay, now we really have a problem." She went on to explain that both files had been received within the past half hour. Each file represented a patient currently in a local emergency department. Each patient required a specialized medication pump. "We only have one pump left," said the nurse, "and we have to decide who gets it. What do we do?"
Decisions such as this are made every day in healthcare. I wonder how often there's anything on the file that even resembles a directive or advance care plan indicating the patient's wishes. What does the patient want? How would healthcare providers distant from the patient (like my colleague and her staff member)have any idea about the patient's preferences, needs, and personal beliefs?
Just wondering.