MORPHINE and Dying Patients - page 13

Curious about the administration of pain medication (Morphine) and possibly speeding up a patient's death.... Read More

  1. by   ted53
    Hi NOMORE, what you are voicing has been voiced by every good nurse who ever entered the profession. If you titrate the dose and your patient's pain has been properly assessed then you are not overdosing your patient. We have natural opoid receptors in our body which makes morphine such a good pain killer. If you need more information read up The Gate Control Theory of Pain.
    Of course at the very end stages you may be slightly overdosing your patient but the goal should be a pain free patient.
    Remember everyone has the right to die with dignity, to die pain free and not to die alone. Sometimes when patients die the only other people present are nurses. I have never had any problem doing nothing else but sit with a patient breathing their last.

    regards

    Edward
  2. by   safta24
    Edward ,

    Good to know there are nurses like you around the world. Thanks

    season's greetings Safta24
  3. by   leslie :-D
    Quote from safta24
    Edward ,

    Good to know there are nurses like you around the world. Thanks

    season's greetings Safta24
    and thankfully, there are a lot more nurses, just like ed.

    leslie
  4. by   scooterRN52
    Quote from bb333
    I worked with an anesthesiologist in surgery who took a leave of absence when his mother was dying. He said he wanted to be there to be sure she received enough morphine since it was one of the few drugs that masks air hunger in the dying patient. He said the restless behavior we see in these patients is related to this and for them to have a peaceful death morphine should be titrated so they can have a peaceful passing. This has always stayed with me, and along with pain control is the chief benefit for the dying patient. I have put it in my advance directive to my family so I may have the same benefit when the time arrives.
    I work in a cancer center and beleive me I have seen many dying patients and mso4 is a great drug, but younger Residents are afraid to use it. Morphine dilates pulmonary vessels and helps the dying pt. ease into a peaceful sleep without air hunger and people should not worry about a dying pt, becoming dependent on
    pain killers when they are dying and it doesn't matter. Ativan and mso4 are synergistic and work very well together to relieve the pain and anxiety of death.:icon_wink:


    scooterRN52
  5. by   scooterRN52
    Pain is the 5th vital sign and pain is always what the pt.reports it as. I am an oncology nurse for past 11 years and pain rescource nurse at our hospital. I see alot of pain, believe me.
  6. by   hospiceprn
    To all who have little to no experience with MSO4,
    Learn all you can and read as much as possible about Morphine and pain. This is a very important drug with dying pts. Many nurses are afraid of it. There is nothing to fear as long as you use it correctly and follow your 5 rights and it can be the difference between a painful, Oxygen deprived, traumatic nightmare for Pt, family, and nurse or a peaceful calm and quite passing. I have been in your shoes about the morphine dilemma, and it is very scary. When I got off my bottom and did research on my own, which still continues to this day, I learned a great deal and was no longer afraid of morphine and haven't ever since then, questioned doctors orders or my actions.

    There are alternatives for pts with morphine allergies. I urge any nurse who works with dying pts. to educate yourself and know your tools and how they work.
  7. by   hospiceprn
    ScooterRN52,

    That is a great way to think of pain. I always check it first with my vital signs so why not. Cool, Thank you, and I will pass it on at my hospice.
  8. by   safta24
    scooter & all that are concerned with the giving of morphine amy your advice be superimposed to all nurses * docs. I for one feel better for all this thanks
  9. by   Sabby_NC
    Quote from scooterRN52
    I work in a cancer center and beleive me I have seen many dying patients and mso4 is a great drug, but younger Residents are afraid to use it. Morphine dilates pulmonary vessels and helps the dying pt. ease into a peaceful sleep without air hunger and people should not worry about a dying pt, becoming dependent on
    pain killers when they are dying and it doesn't matter. Ativan and mso4 are synergistic and work very well together to relieve the pain and anxiety of death.:icon_wink:


    scooterRN52
    They are my two fav drugs in caring for my hospice patients.
    I have also used Dilaudid and Fentanyl in my patients with Morphine allergy as well with great results.
  10. by   GrumpyRN63
    I have no reservations at all about giving seemingly huge doses of Morphine or Dilaudid to a terminal ptNo dose is high enough until the patient is comfortable. Death should be peaceful, easy, not a painful ,struggling ,gasping, anxiety ridden end... We will all die,we SHOULD all die with peace, grace, dignity and serenity .What an awesome gift we can provide. It may be helpful to talk with a palliative care nurse to gain more knowlege/understanding, or a seminar on the subject.
  11. by   scooterRN52
    Quote from Sabby_NC
    They are my two fav drugs in caring for my hospice patients.
    I have also used Dilaudid and Fentanyl in my patients with Morphine allergy as well with great results.
    Thank-you for mentioning allergy to mso4, it is rare but it is out there. Dilaudid and fentany are drugs we use also and they are even stronger than mso4. If I were dying of cancer, I would take mso4 and ativan to relieve the pain and anxiety.
  12. by   katsanrn
    I have read the post on this subject and I say good job to all you. To the new nurses and the nurses to be, just remember to check the five rights of medication adminastration and don't be afraid to be a patient advocate, that is a BIG part of our job as nurses.
    I have worked as a Hospice nurse and have given what some would say "is enough to kill a horse". This belief is not true as it takes more pain medication to control terminal/chronic pain. Please don't be afraid to ask the provider for higher doses if you see that the patient is still suffering. The patient and thier family will both be thankful.

    Happy nursing to us all and may we all keep on caring!!!!!!
    Last edit by katsanrn on Dec 27, '07
  13. by   Sabby_NC
    Quote from scooterRN52
    Thank-you for mentioning allergy to mso4, it is rare but it is out there. Dilaudid and fentany are drugs we use also and they are even stronger than mso4. If I were dying of cancer, I would take mso4 and ativan to relieve the pain and anxiety.
    Awww you are welcome

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