Hypothetical, yet sticky situation for a new grad - page 2
Hi All, This morning, I woke up to the awful news that a neighbor of mine passed away early this morning. He had been diagnosed with stage IV stomach cancer, and had begun hospice care earlier... Read More
Jul 18, '10Regarding your original hypothetical situation, here's how I would answer; with another hypothetical situation . . . if you were visiting your friend in the hospital, and the friend was in pain, and you saw a carpuject of some analgesic med on the counter, would you administer it? I would guess, your answer would be, "Are you crazy????" So, that's my answer to the original hypothetical situation, too.
BTW, I won't even silence an IV pump when visiting a friend/relative in the hospital. But, I will look for the nurse (for both the pain and the pump alarm!)
Jul 18, '10I cannot, under my license, legally give him the shot unfortunately. I would've taken him to the closest ER, should he be willing to go.
Or call the agency and see if another nurse would be willing to come out.
Jul 18, '10I would have talked to the hospice nurse seen as there was anything i could have done as a supportive friend, not in the role of nurse. (Hospicecare supports family in their care of their family as well, so family often adminsters medication, sometimes family is sooo paniced they can't remember what their suppose to do, so being a calming force be all they need to support them). At the end of life we want to control pain even if that inadvertantly shortens the life by a small amount. Our nursing code of ethics supports this. Im sorry that he did not have his pain controlled at the end, but what an honor that it was you that they thought of as someone that could help them. but i agree sublingual morphine should have been available for the family to administer.
Jul 18, '10[If in weighing risk versus the depth of your friendship you decided to help, here's how I would have approached it. Do an assessment of the patient. Call the hospice nurse and find out what medication (dose, route, etc) should be given. Then give the med. IMO, the morphine did not kill the patient. Cancer killed him. The morphine just helped ease his pain during the process. A hospice nurse once told me, "We all have to die, we just don't have to die screaming."]
It's a tough call for a new grad. I'm glad you knew that, it speaks well of your judgement. The quote I copied above from azhiker really says all I'd say. You sound like a good nurse. Via con Dios.
Jul 18, '10i faced a similar situation several years ago. i was a hospice volunteer but not a hospice paid insured rn, in the house where the spouse was a colleague of my husband's and i was a childhood friend of her husband, the patient. they were best friends and i felt like a skunk refusing to give his morphine gtts,
but his older sister was also there. she had been a very difficult kid and had been nasty, belittling, sarcastic, threatening, and generally obnoxious for the week she had visited, with her brother, in-laws, the hospice rns, and me, the lowly volunteer.
she had told everyone within earshot that she was watching and would sue hospice if she saw anything at all she thought was questionable. she had the hospice staff on edge while the wife appreciated absolutely everything we did for her husband. if his sister hadn't been there, after checking the order, being asked by the wife, i would have done it. no, none of his meds were locked up.
but had the sister of the patient not been there criticizing her (and everything else) the wife would have been able to do it herself. the sister did not believe in the size and frequency of his pain meds dosages so she refused to administer any of them.
he died later that evening.