My best friend in nursing school was ordered to terminally sedate a stroke patient. - page 3

He was comatose and given little chance of recovery (but was breathing on his own). His family wanted nothing to do with the guy because they said he was a child molestor. A medical review board at... Read More

  1. by   jnette
    Quote from sbic56
    Sometimes being right means doing the "wrong" thing.
    Again, I agree with you, sbic, and wholeheartedly so.

    I would reword the above, however to "Sometimes being 'wrong' means doing the right thing."
  2. by   sbic56
    Quote from sbic56
    Ya know, you are absolutely right, bluesky! With all the moral/ethical debate, I totally missed the part where a student was being allowed to push morphine!
    Well...if you go to this school of nursing, it's permitted:

    http://web.uccs.edu/bethelstudenthandbook/iv.htm
  3. by   sbic56
    Quote from jnette
    Again, I agree with you, sbic, and wholeheartedly so.

    I would reword the above, however to "Sometimes being 'wrong' means doing the right thing."
    Yup...I like your choice of words; same intent, but you said it best!
  4. by   Tweety
    Quote from sbic56
    Ya know, you are absolutely right, bluesky! With all the moral/ethical debate, I totally missed the part where a student was being allowed to push morphine!
    Students can't push morphine??????????? Been so long I forget, but I'm pretty sure in my surgical rotation I pushed narcs.
  5. by   sbic56
    Quote from 3rdShiftGuy
    Students can't push morphine??????????? Been so long I forget, but I'm pretty sure in my surgical rotation I pushed narcs.
    I believe it must vary...we couldn't in our program, but after doing a quick search, (see above) I found a place that had it's use in their student guidebook. Thinking of it now, it is crazy to not let a student do it with the instructor present, as then, they go on the floor with absolutely no clinical experience in doing it and have to learn to do it in orientation. Must be a liability issue that the schools just want no part of.
  6. by   Angelica
    I pushed morphine as a student.
  7. by   KBnursestudent
    Quote from CHIRN
    Often, when a family decides to remove a patient from the ventilator and all other life sustaining medications we have morphine standing by ready to push. Most families that want to be in room when their loved ones die have great difficulty with the agonal breathing that occurs right before death. Most doctors order this pushed to spare the family. I have ethical questions about this practice but I have never refused to push the morphine. If this is active euthanasia then I suppose I am guilty. However, I will continue to help those in need (patient and family) ease the burden of dying.
    Speaking if the pt were me, I woudl say taht if I were dying and I were in pian and agony with breathign.(my worst fear is to die of suffication or horrible pain) I would much rather them allow me the comfort of sleeping through my death. If the guy is agonizing with labored breathing and there are orders to push the meds then why not make the guy comfortable?
  8. by   KBnursestudent
    Quote from prmenrs
    I believe this assignment is inappropriate for a student. Whether or not this was an appropriate course of action for the pt. is hard enough for working RNs to figure out, students should NEVER be put in such a position.
    I agree that a student should never be asked to do this. If I were that student I would tell my instructor taht I was very uncomfortabel with this and could she reccomend the assignment be given to a nurse in the hospital.
  9. by   ExquisiteRevelation
    Quote from caroladybelle


    But no one (instructor/student/staff) should ever commit an aact that cannot be discussed due to "implications". Like the bit with the side rails, if they are restraints, then the MD better darn well write an order...or better yet explain to the public why enacting "restraint free" laws impair our ability to protect the elder population. To turn a blind eye to such things, just leads to more really stupid legislation. I have a problem with an instructor that would do something that she did not think was 'discussible" - that I find inappropriate.
    Very well put.
  10. by   CCU NRS
    Quote from orrnlori
    Uh......I think this post was in jest, was it not?
    I may be wrong but the post I was responding to did not seem to be jest to me looking back I see the chuckling man in front of it and the party guys at the end so perhaps you are right or perhaps the poster was just really happy a child molestor was dead
  11. by   gypsyatheart
    I'm not sure of the role of the student here, most programs don't allow for pushing IV narcs until your senior semester, if at all; but I agree this story sounds "fishy"...the OP doesn't seem to have a lot of specifics here....I don't know something just doesn't "feel" right w/this story....
    Maybe it's just a student, very new clinical student, not really understanding what was happenning....?
    And what happenned to these students (medical) ethics classes, BTW?

    Quote from bluesky
    I don't see how a student would be allowed to a)use a PCA or b) IVP morphine. Most programs I know prohibit both. Something sounds fishy with this story...
  12. by   Vsummer1
    In my program, we are not allowed to push morphine or to even do anything with the PCA pumps. This may be hospital policy, or the comfort of the instructors and their licenses. However, we are dealing with these patients and these issues. We just are not the one to give the shot.
  13. by   caroladybelle
    Quote from sbic56
    It is not unusual for MS to be give in this way to a terminal patient and certainly does not describe euthanasia in my mind. Someone please explain why they believe this instructor is so wrong, immoral , etc...
    It is euthanasia because the drug is clearly not being given to ease suffering.

    It is being given to kill a patient or to hasten their demise and for no other reason, whatsoever.

    At NO point in the OP is pain or suffering even remotely mentioned or indicated in the post. The patient is not suffering from a condition that is generally painful in most cases. The vast majority of terminal strokes (though not all) go quietly and peacefully in the death.

    There is nothing whatsoever to indicate a painful death in this situation. Therefore morphine is not indicated.

    The other issue is the instructor not adequately explaining the situation. My position is, if you can't explain to the student, it is probably the wrong thing to be doing in front of them.

    I wish nurses would get a back bone in these issues. If all side rails need to be up, get a darn order from the MD. He won't order it, chart his repeated refusal. The MD wants to hasten a death. Make him get his butt out of bed, come in do it himself, and stay by the bed while it happens. The family wants us to "help" the patient die, well they can take them home if that means so much to them. Let them go to court.

    But it is not my job to kill them.

    There is a difference between giving morphine to a terminal patient that is pain and has slow respirations...and set up a drip for no other purpose other than to kill.

    And we should be teaching students the difference, ...which obviously did not occur in this case.

    And "slow" codes and "snowing" patients is a wimp's way out.

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