[heyday]

I'm in my first year of nursing school, and I just learned about the underground issue of "snowing"--giving patients enough morphine to keep them out of pain but ultimately totally depressing their respiratory centers. I have never heard of this euthanasia-like thing before, and I was wondering if the decision really does come up for most people? And what could you do if asked to do this but did not feel comfortable with it?
Thanks!

[babynurselsa]

The term snowing is not necesarily a term in reference to euthanizing someone. The term is often used in reference to someone who becomes sedated after medication. I can take Benedryl and I am snowed for at least 12 hours.
I have worked in the hospital and as a Hospice nurse. I will treat a patient's pain(especially someone who is terminally ill) so that they are able to achieve the most comfortable state possible. It is not my intent to hasten someones demise. I will be generous as my physician orders will allow to alleviate somone's suffering.

[Tweety]

Good question.

"Snowed" means sedated.

There are people dying who are in horrible pain. It's a dreadful way to die. Sometimes we as nurses are called to give them pain medicine until they are sedated and no longer moaning in pain, and thus their respirations are lessened.

In my opinion to withhold pain medicine to a dying patient just because their repirations will be descreased is cruel.

[Nemhain]

Originally Posted by babynurselsa

The term snowing is not necesarily a term in reference to euthanizing someone. The term is often used in reference to someone who becomes sedated after medication. I can take Benedryl and I am snowed for at least 12 hours.
I have worked in the hospital and as a Hospice nurse. I will treat a patient's pain(especially someone who is terminally ill) so that they are able to achieve the most comfortable state possible. It is not my intent to hasten someones demise. I will be generous as my physician orders will allow to alleviate somone's suffering.

Good post babynrselsa. I'm just here to join the choir and say that everyone who is terminally ill does deserve to have their pain alleviated even though it may ultimately hasten their death.

For the OP...For example, my friend's father was terminally ill with cancer and the doctor said he'd only live for 2 weeks tops if he was to receive no pain meds. He went on to explain that my friend's father had the right to have a pain free death, but the amount of meds that it would take to rid him of his pain and make him comfortable would probably kill him in 2-3 days. Would anyone make this cancer patient suffer in excruciating pain so he could live in agony for 2 more weeks? Hopefully, no.

It would be unethical and illegal, however, to give a morphine bolus to grandma to send her on her way tonight when she only needed a little vicodin and was thought to live another 2 mos. Do you see the difference?


Oh, as far as the term "snowing" in the hospital it would be what babynurselsa said, but I think I heard the term "snowed" on the show "The Soprano's"!?!? I think they meant it as "kill"...Tony "snowed" someone last night. Hmm....

[Nurse Valium]

I fully support treating a patient's pain and feel it is immoral not to do so. Whatever the amount or the drug to achieve patient comfort.

It was once proposed to me by co-workers at a LTC facility that since "Ms M." was going to go anytime that perhaps I could help her along the way with the sliding scale morphine order. I adamantly declined to purposefully euthanize her but did treat her pain throughout my shift that night & kept her comfortable to the best of my ability.

Have never been confronted again with that 'idea' again so cannot answer for you how prevalent the practice is.

Hope that answers your question.

[rogramjet]

What you are talking about I have heard called the "Rainbow Effect". You give them enough pain meds to stop the pain and it supresses the respiratory system. My Mom was in amazing pain when she died of cancer, and the doc warned us about this, but her systems were all shut down anyway. Sometimes you have to give enough narcs to kill the pain, and yes, sometimes that hastens a death which is usually inevitable anyway.

[JentheRN05]

I had this with both my mom-in-law and my grandfather. Both were in hospice and both, ultimately died from overdose, when death was inevitable anyway. I remember my grandfather distictly. He was moaning quite a bit, we had to continue giving him morphine (SL) because of it. He possibly would've lived a couple more days, but no one wanted to prolong his agony due to risk of respiratory depression. So we gave it to him. He died quietly, in no pain I'm sure

[Laurell28]

There is a very good statement at the HPNA website regarding opiods at end of life, particularly in regards to respirations. In a nutshell it says that there is no conclusive proof that opiods at the end of life will hasten a death. I'll try and copy the link but to be honest I'm not exactly sure how to do it.

http://www.hpna.org/pdf/Providing_Op...tement_PDF.pdf

[Grace Oz]

Isn't language and terminology intriguing and sometimes funny.
Here in Oz, we have a saying; "snowed under", which means that you are overloaded with work, trying to catch up, busy.

[purplemania]

read up on palliative care. There is a website by palliative care nurses (and others) that gives insight to this question. www.nhpco.org