[ShayRN]

People come here, you give them morphine and they die.

I am so frustrated with people thinking that because someone is on morphine, they die. HELLO! Your loved one has breast/brain/colon/rectal cancer THAT is why they are dying. Your loved one is 95 years old THAT is why they are dying. Your loved one is gasping for every breath from the fluids backing up from their CHF, THAT is why they are dying. But NO, can't get that through their heads, it is that darn morphine we give.

I just had a man tonight tell me he heard on the radio "about 6 weeks ago a woman just blasting you all for killing her mom with that morphine." I tried to explain to him that morphine benefits the patient in that it not only helps the pain, it also helps with air hunger. Nope, didn't want to hear it. Then I said to him, look, they are not dying because they are on morphine, they are on morphine because they are dying. Usually that helps clarify things, but nope, not gonna fly with that one... Luckily, his sister has DPOA and she refused to let her mom be moved to the hospital. But HELP!!!! What do I say to this?

BTW, our inpatient hospice facility has a >68% return on patient satisfaction surveys with 100% patient satisfaction last year in 3 quarters and 98% in another. Yeah for us! I am so darn proud of my co-workers, they are the BEST!

[sassysteph7]

I work Hospice part time and agency full time and I understand that trying to convince families that morphine doesn't kill, the disease kills, is frustrating. However, I hate it even more when I hear other nurses and cna's start chattering about "hospice was in here today and they started mrs. so and so on morphine. you know what that means!". I just want to carry a huge sign on my back and have it say MORPHINE IS NOT THE REASON HE/SHE DIED.

[earle58]

no matter what you say, many are still in denial and have tremendous knowledge deficits.
there are too many dynamics at the eol, between pts, families and caregivers.
the only way one can accept a truth, is when acceptance has been attained, and objectivity produces understanding.

w/o morphine, the body is in an acute state of stress.
adrenaline and cortisol are both high, producing pain, anxiety, resistance.
when morphine is administered, it allows the body/mind to rest or stabilize.
stress hormones have decreased, enabling the disease process to take over.
and so, yes, they die from the actual disease and its process.

if they choose not to believe this, there is nothing you can do.
just make sure you document your attempts of educating, and family's response to said input.

denial is a powerful mechanism.
you're doing just fine, shay.

leslie

[Em1995]

Hi!
I've found this to be a pervasive belief amongst the public, in general, and especially with some nurses and docs. So, I decided that as part of my job, I needed to institute in-services in facilities and within the community. Groups like the Rotary Club, churches, and schools are good starting points. I offer learning opportunities and always keep this as an interactive session. People are encouraged to ask questions, find out what hospice is all about and I'm able to help them realize that the "dreaded morphine" is not about euthanising, but to keep the patient comfortable. I also encourage people to share their feelings and to use this time of transition to assist the patient in resolving whatever conflicts they may have that are contributing to the pain they are feeling.I try to educate them that hospice isn't about "just giving morphine"; it's all about living and transitioning. Fortunately, I work in a hospice where administration fully supports us in doing things like this.