artificial feeding-Terri Schiavo - page 27

I posted this here becaue I think this subject is something that we as nurses deal with on a regular basis.....Many many people state that they have a big problem with the feeding being stopped... Read More

  1. by   Kyriaka
    Quote from danu3
    Well, I don't know about in Fl. But in Ca, you need to have 6 months or less to live (estimated by doctor) to be in hospise. If Terry does not have a terminal condition, she would not be in hospice in Ca.

    Does the Hemlock Society purposly use words to make people think it is hospise?

    -Dan
    ______________
    I personally think it is on purpose to confuse people. Their web sites use the words/phrases:

    "You have reached the web site for End-of-Life Choices and Compassion In Dying."

    "Compassion & Choices maintains the mission of improving care and choices at the end of life."


    "Our goal is to persuade our elected officials to support the majority of Americans who believe in death with dignity"
  2. by   knockandhello
    Quote from BRANDY LPN
    If I were the nurse and the husband said "no rehab, you cannot do ROM, you cannot perform basic nursing interventions to prevent contractures" I am sorry but I would NOT obey this. I do not need a doctor's order to perform basic nursing tasks such as ROM and positioning to prevent contractures. It would be MY LICENSE on the line if I neglected my pt in the way that is being described!! I don't care WHO said I was not to perform these basic functions, it would be up to me and MY NURSING JUDGEMENT to decide if I followed these orders! There have been numerous referrences made to this ladies "contractures" and contractures are the result of poor nursing care, you do not need an OT or a PT to perform ROM, you do not need a dentist to provide good oral care. So basically my question is why on earth are these nurses complying with this mans "orders"? And how on earth have they avoided discipline by the BON? Why has this not been reported? These nurses are supposed to be held to the standard of care, or what another prudent nurse would do in that situation, Would any of you have treated this pt in the same manner being described? I am just curious we are supposed to be pt advocates and I dont see how it would matter which side of the arguement you are on even if you believe te feeding tube should be removed shouldn't she still recieve AT LEAST basic nursing care while she is alive?

    Please respond to this post, this is something that bugs me way more than any other aspect in this case, the apparent lack of nursing interventions. I am still on the fence on the greater issue of feeding tube vs. no feeding tube and without seeing ALL of the evidence assessing the pt and reviewing the medical record I can't make a decision, I know what *I* would want but this is not me. But please respond as to your feelings on the standard of care this pt has recieved.
    I agree wholeheartedly with above.What would their nursing care plan for Terri look like?How can the care facility justify their lack of duty to care to this lady.I would find it a disturbing place to be employed at.
  3. by   RNinOR31
    Quote from mercyteapot
    Congress is not making a decision as to whether Terri Schiavo lives or dies. They are making the decision to ask a federal court to review the case. We do this in death penalty cases, routinely. Convicted murderers have the right to petition pretty much every court in their own state and at the federal level. Why is it so horrible to ask the courts to intervene in this case? Terri's death will be just as final.

    With all due respect, it has been reviewed, multiple times. In all of the cases of review it was found that the Guardian (Michael) has the right to make the final decisions. Terri's parents have appealled all of the court rulings. All of the previous appeals have been denied. Congress had to pass a bill in order for it to be RE-reviewed. This will buy time for the parents of Terry to appeal the denial of this current temporary injunction and reinsertion of her peg tube. This has been going on for years. It's very sad really.
  4. by   pizzigirl
    Quote from knockandhello
    I agree wholeheartedly with above.What would their nursing care plan for Terri look like?How can the care facility justify their lack of duty to care to this lady.I would find it a disturbing place to be employed at.
    Hi,
    I've been reading this forum for several days now, but I have only been compelled to post a message after reading postings re: Terri Schiavo. I have just finished reading the "Wolfson's Report". The report submitted to Gov. Bush and the Florida courts by the Guardian ad litum who was appointed by the courts. I encourage EVERYONE that has been posting to this site to read it. I have read a lot of postings that refer to what Michael Shiavo may have done to his wife or may not have done for her. In my opionion he has been a very supportive, loving, grieving husband to Terri. Read the entire report. Don't just repeat what you may have heard from a co-worker or news cast or radio show. Get the facts. Then write back and let us all know what you think of this man that many of you are accusing of having less than honorable intentions. There is also a web site that lists the entire timeline of the Schiavo case with links to various court proceedings. It is http://www.miami.edu/ethics/schiavo/timeline.htm. Check it out.
  5. by   igloorn93
    Doesn't the government interfere enough in our lives already? If Terri didn't want her husband to speak for her she should have had a power of attny stating that her parents were to make decisions for her. I too have to wonder why he hasn't divorced her and married his new woman, the mother of his children, but perhaps he does it for the better of Teri. We don't know what kind of relationship she had with her parents prior to her heart attack, nore do we know what kind of relationship she had with her husband. Perhaps he truely does feel that he is acting in her best interests. A question to which none of us will ever know the true answer. I hope this tragic case becomes an example to others the importance of living wills and powers of attnys. Take the burden away from your loved ones. Make it easier for them. Have it spelled out on paper. If you start to feel better and can communicate somehow, you can always change your wishes. All this removal and reinsertion of the feeding tubes cannot be good for her either. It's a truely tragic situation no matter how you look at it. The one person who is suffering the most can no longer speak for herself. It's time to let the one person the law dictated years ago (long before this case came to be) who has the power to make the decisions to decide what is best for his wife. In my humble opinion that is.
  6. by   fergus51
    Fortunately the latest judge has decided not to force doctors to reinsert the tube. Hopefully this woman can go in peace.
  7. by   NurseFirst
    Quote from kbclary4
    all i can say is right or wrong, the husband has the legal rights, not the parents. he says she would not want to be in that state and if he's lying, he'll have to answer for it eventually. if it were me and i had not written a will, i would not want my parents or any other family or friends trying to over-rule my husband's decision because he knows what i want and legally he is my next of kin. i read on msnbc that someone offered the husband one million to leave it in and he refused which leads me to believe money is not his motive. really his motive is not an issue because legally, if there is no will the spouse's decision is the one upheld by the law.
    this has become an issue about "face" and/or power. if it's not about money, then perhaps people are right, it's about his fear that she will recover enough of her brain function that she could accuse him. there definitely is a mismatch in michael's supposed fighting for terri's will and his action in relationsihip to other requests for terri, which have been enumerated on this thread.

    nursefirst
  8. by   James Huffman
    Quote from pizzigirl
    In my opionion he has been a very supportive, loving, grieving husband to Terri. Get the facts. Then write back and let us all know what you think of this man that many of you are accusing of having less than honorable intentions.
    Sigh.

    Once again, the loving Michael Schiavo. Devoted, supportive and grieving husband.

    And the information from Carla Sauer Iyer, R.N., Ms. Schiavo's nurse:

    "It was clear to me at Palm Gardens that all decisions regarding Terri Schiavo were made by Michael Schiavo, with no allowance made for any discussion, debate or normal professional judgment. My initial training there consisted solely of the instruction "Do what Michael Schiavo tells you or you will be terminated." This struck me as extremely odd."

    and

    "I was very disturbed by the decision making protocol, as no allowance whatsoever was made for professional responsibility. The atmosphere throughout the facility was dominated by Mr. Schiavo's intimidation. Everyone there, with the exception of several people who seemed to be close to Michael, was intimidated by him. Michael Schiavo always had an overbearing attitude, yelling numerous times such things as "This is my order and you're going to follow it." He is very large and uses menacing body language, such as standing too close to you, getting right in your face and practically shouting."

    and

    "To the best of my recollection, rehabilitation had been ordered for Terri, but I never saw any being done or had any reason at all to believe that there was ever any rehab of Terri done at Palm Gardens while I was there. I became concerned because nothing was being done for Terri at all, no antibiotics, no tests, no range of motion therapy, no stimulation, no nothing. Michael said again and again that Terri should NOT get any rehab, that there should be no range of motion whatsoever, or anything else. I and a CNA named Roxy would give Terri range of motion anyway. One time I put a wash cloth in Terri's hand to keep her fingers from curling together, and Michael saw it and made me take it out, saying that was therapy."

    and

    "Throughout my time at Palm Gardens, Michael Schiavo was focused on Terri's death. Michael would say "When is she going to die?," "Has she died yet?" and "When is that ***** gonna die?" These statements were common knowledge at Palm Gardens, as he would make them casually in passing, without regard even for who he was talking to, as long as it was a staff member. Other statements which I recall him making include "Can't you do anything to accelerate her death - won't she ever die?" When she wouldn't die, Michael would be furious. Michael was also adamant that the family should not be given information. He made numerous statements such as "Make sure the parents aren't contacted." I recorded Michael's statements word for word in Terri's chart, but these entries were also deleted after the end of my shift. Standing orders were that the family wasn't to be contacted, in fact, there was a large sign in the front of her chart that said under no circumstances was her family to be called, call Michael immediately, but I would call them, anyway, because I thought they should know about their daughter."

    and

    "Any time Terri would be sick, like with a UTI or fluid buildup in her lungs, colds, pneumonia, Michael would be visibly excited, thrilled even, hoping that she would die. He would call me, as I was the nurse supervisor on the floor, and ask for every little detail about her temperature, blood pressure, etc., and would call back frequently asking if she was dead yet. He would blurt out "I'm going to be rich!," and would talk about all the things he would buy when Terri died, which included a new car, a new boat, and going to Europe, among other things."

    and

    "When Michael visited Terri, he always came alone and always had the door closed and locked while he was with Terri. He would typically be there about twenty minutes or so. When he left Terri would would be trembling, crying hysterically, and would be very pale and have cold sweats. It looked to me like Terri was having a hypoglycemic reaction, so I'd check her blood
    sugar. The glucometer reading would be so low it was below the range where it would register an actual number reading. I would put dextrose in Terri's mouth to counteract it. This happened about five times on my shift as I recall. Normally Terri's blood sugar levels were very stable due to the uniformity of her diet through tube feeding. It is my belief that Michael injected Terri with Regular insulin, which is very fast acting."

    and

    "The longer I was employed at Palm Gardens the more concerned I became about patient care, both relating to Terri Schiavo, for the reasons I've said, and other patients, too. There was an LPN named Carolyn Adams, known as "Andy" Adams who was a particular concern. An unusual number of patients seemed to die on her shift, but she was completely unconcerned, making statements such as "They are old - let them die." I couldn't believe her attitude or the fact that it didn't seem to attract any attention. She made many comments about Terri being a waste of money, that she should die. She
    said it was costing Michael a lot of money to keep her alive, and that he complained about it constantly (I heard him complain about it all the time, too.) Both Michael and Adams said that she would be worth more to him if she were dead. I ultimately called the police relative to this situation, and was terminated the next day. Other reasons were cited, but I was convinced it was because of my "rocking the boat.' "

    and

    "While at Palm Gardens, I became fearful for my personal safety. This was due to Michael's constant intimidation, including his menacing body language, vocal tone and mannerisms."

    [end of quotes from Ms. Iyer]

    I will be impressed with Michael Schiavo's loving, devoted attention when someone can cite concrete information rather than giving their own opinions.

    Jim Huffman, RN
  9. by   Spidey's mom
    Quote from NurseFirst
    This has become an issue about "face" and/or power. If it's not about money, then perhaps people are right, it's about his fear that she will recover enough of her brain function that she could accuse him. There definitely is a mismatch in Michael's supposed fighting for Terri's will and his action in relationsihip to other requests for Terri, which have been enumerated on this thread.

    NurseFirst
    I personally think this is a power play for the euthanasia crowd, the supposed right-to-die folks, The Hemlock Society. They can't lose face now-this is a huge win for them and money can't dissuade them.

    steph
  10. by   Tweety
    Quote from stevielynn
    I personally think this is a power play for the euthanasia crowd, the supposed right-to-die folks, The Hemlock Society. They can't lose face now-this is a huge win for them and money can't dissuade them.

    steph

    Not that the right to life folks and some Christian right folks aren't posturing either, many of whom have offered money to keep her alive. Also, a bit of political posturing on the politicians side. They get TV time acting all moral and high and mighty. Can't help but wonder if their voting their conscious, what their consitutients want, or what will also gain them politically.

    But just because people have strong belief's prior to this case, and this case is an example of their beliefs and they strongly want the case to go their way, doesn't mean they are in a power play. So I'm not seriously buying into the "power play" idea on anyone's side. I think people are just passionate about their beliefs one way or another.
    Last edit by Tweety on Mar 22, '05
  11. by   Spidey's mom
    This isn't a case of the government "interfering" . . . the government is simply living up to the Constitution, specifically Article III . . .

    And people keep saying that if Terri didn't want her husband to speak for her she should have made some legal arrangement before she became brain damaged. That is just crazy - most people that young don't have anything written legally. So we allow a spouse to have the right to kill another spouse just because she forgot to write something down??

    There has to be a legal avenue to protect everyone's right to life, liberty and the pursuit of happiness.

    When someone gets sick without making plans then some authority has to step in and see that their rights are protected.

    Otherwise we have chaos.

    steph
  12. by   Spidey's mom
    Quote from Tweety
    Not that the right to life folks and some Christian right folks aren't posturing either, many of whom have offered money to keep her alive. Also, a bit of political posturing on the politicians fault. Can't help but wonder if their voting their conscious, what their consitutients want, or what will also gain them politically.
    Of course you are right that the pro-life crowd is rallying behind Terri's parents.

    I see nothing wrong with either side taking public stances .. . I was just theorizing about why Michael didn't take the money.

    This is a serious issue for both sides and both are determined to win.

    steph
  13. by   Tweety
    Quote from stevielynn
    There has to be a legal avenue to protect everyone's right to life, liberty and the pursuit of happiness.

    Otherwise we have chaos.

    steph
    You're forgetting they used to court system to the max. Bringing all the way to the Supreme Court, which refused to hear the case. So yes, there is a legal avenue and they have persued it.

    I'm not saying I 100% disagree with congress getting involved. It's not the first time the congress has made laws thwarting the courts, in favor of the best interests of the public. But I want to point out Terri and family weren't without any legal avenues, they just haven't gotten the answer they wanted to hear. That's not a judgement, I don't blame them.

    And as you've pointed out, the court isn't without it's flaws.

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