This article describes the despairing nursing experience of physical and psychological impact in a patient with amyotrophic lateral sclerosis suffering from respiratory failure combined use of mechanical ventilator due to disease progression and receiving the unattainable training of weaning from mechanical ventilation. The motive of this study is the case appears to deny and hopeless because of realizing the physical and spiritual double threats of incurable disease progression and difficult training of weaning from mechanical ventilation. Data were collected from observation, discussion with the family members, physical assessment, direct care, and chart review during a period of nursing care from September 12, 2014 to October 15, 2014. Based on Gordon's eleven functional health patterns, the main nursing problems of patient confirmed included: ineffective method of clearing airway, altered nutritional status, and hopelessness. During the nursing process, the author helped the case to train his breathing by having passive chest muscle rehabilitation activities, improving the strength of chest muscle and clearing sputum, and successfully wean from mechanical ventilation. Appropriate adjustment of the nutritional formula enhances case nutritional intake to get the demand of body by using cross-team integrated care to joint intervention and evaluation. Assisted the patient toward disease, subsequent treatment and the fact of disease with forward attitude through companionship and active listening the idea of his family. In addition, the author recommends that health care team through a family meeting to discuss the tracheotomy or select hospice palliative care to reduce the sufferings of the patient and his family and allow the patient to spent the rest of his quality life.