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

CCU NRS · Apr 13, 2004

That doesn't mean it was the morphine that killed him. But it is hard to tell without individual assessment.

I concur but the situation is really a serious case for speculation and nursing students should be able to learn in a setting that is conducive to positive ideas and discussion of serious matters should be considered without a student being placed in a postition that could cause legal ramifications not to mention moral delimma that is really best suited to yeas of experience. I am not saying students should no see and discuss cases such as these, they should but a student should not be put in a position to perform this task IMO!

BabyRN2Be · Apr 13, 2004

OK, I've read this entire thread. I think my suspicions are dead on in this one. Like someone said earlier, except for a few changes, this was taken almost entirely from Echo Heron's book. From a person who didn't have a shot at life, an instructor who was essentially forcing a student in a situation in which she was not ready, to the 10mg bolus dose of morphine.

That's my number one problem.

2. The OP originally said it was her "best friend" who pushed the morphine. It

then changed to the "instructor" who actually pushed the MS (much like

Echo Heron's book).

3. The OP hasn't said what year student her best friend was.

4. Wasn't sure if morphine had a trade name or not.

5. Never mind the legalities of student's being able to push MS.

6. 10mg bolus MS plus 2mg every hour probably isn't going to kill someone

the next day, we don't know how narc sensitive this guy was in the first

place.

7. The OP really hasn't been back to defend the whole story with further

details!

I'm really not one to rush to judgment, but I tell ya, this whole story reeks to high heaven.

But I'll be glad to hear more if the OP has any more details which don't already add to the aroma of the original post.

This is just my opinion. I've read the Echo Heron books too many times. :)

Gotta love her and I hope she comes out with more!

Love767 · Apr 14, 2004

BabyRN2Be, let me address your concerns:

1. Who is Echo Herron and why does it matter? This happened, but even if it didn't it wouldn't change the validity of the issue for discussion.

2. My "best friend" (and I am a he by the way) was ordered to push the drug because it was her patient (we choose are own patients in this rotation which is cardio our third semester of clinicals) and we pass all meds for our patients while we are there, unless we haven't been checked off on the mode of administration. Our instructor, ultimately pushed the drug when she found out the situation because she felt my friend shouldn't have to do so. This sparked a conversation amongst several of the students in our group (and the instructor) concerning the situation.

3. We are in our third clinical semester of a BSN program that runs five semester, not that it matters.

4. I said I wasn't sure what the trade name of the particular drug was no where did I say that morphine didn't have a trade name. I looked it up in my Davis guide and it didn't make a distinction between brand names for IV morphine, maybe it matters but I still don't know what the trade name was in this case.

5. We are able to push all drugs so long as we have been checked off on the method of delivery. Usually the instructor will try to be present if it is an IV or IM.

6. Can't say if the dose killed the patient, but he did die the next day. I also don't know if the dose was later elevated, or if additonal boluses were given.

7. If you scroll up the thread a few inches you will see that I explained a couple of points. Why, should I have to defend a post about an experience at school? Going back to point number one even if I was making up something out of some book (which I didn't!) it wouldn't change the validity of the issue for discussion.

BabyRN2Be · Apr 14, 2004

Love767,

I do apologize for the tone in my post. I guess I was a bit cynical when I read your post yesterday because it sounded like it was really out of Echo Heron's book called "Intensive Care: The Story of a Nurse." The details were almost identical to a storyline from the book when she was asked to do basically the same thing.

If you get the chance to read the book, which I highly recommend, you might see why I have some concerns. Some people get on these boards after reading something shocking like that, something that seems dichotomous in the field of nursing and wonder if anything like euthanasia happens in hospitals. It's the Internet, people troll to get a response. *shrugs*

However, I do say that I was a bit harsh and I do apologize.

[email protected] · Apr 15, 2004

This thread bares alot of discussion, there are pros and cons to the subject as is the case in all ethical situations. I'm sure there was discussion at the hospital where this occurred. The student might not have been privy to all of it. But, along with ethical discussions comes professionalism. Please be careful about calling someone a moron. None of us deserve that kind of disrespect. We need to build up each other and our profession, not tear it down. I understand there are strong feelings involved in issues such as this, but if you weren't there, and don't know all the facts, then you didn't walk a mile in that instructors shoes.

As for me? Well, I'm working on my Masters and on certificates in clinical and bioethics and also in clinical ministry. I'm hoping to carve out a position as a consultant to nurses, patients, families that are in situations like this and to help in the decision making process thats best for everyone. Babinurse

winstonsmom07095 · Apr 15, 2004

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 the hospital made the decision. Here's what bothers me. My friend was ordered to give 2mg/hr IV. (as needed), but told that he would need the medication every hour. Our instructor said that this will kill most patients within a couple of days, and that respirtory depression wasn't "such a bad way to go". She said that this is done in hospitals everywhere only it's just not called what it is. I'm not sure how I feel about euthanasia (there are good arguments on both sides), but the point is that I thought that it was currently illegal in the United States. Is this true or is my instructor just wrong about this dose killing most people within a few days? If it is true is this really common or what? Seems like an attempt to implement a policy (euthanasia) without a public debate on the issue.

That is murder in most eyes. When a doctor gives me an order I don't feel is correct or ethical, I offer to draw up the medication, but if they want it given then they must give it themselves and it is charted as such. Because when push comes to shove, the doctors cover eachother and try to put it to the nurses, (and without any surgilube either).

Alnamvet · Apr 15, 2004

. Our instructor said that this will kill most patients within a couple of days, and that respirtory depression wasn't "such a bad way to go". She said that this is done in hospitals everywhere only it's just not called what it is.

I have opinions, which, like A@#&^%$#, everyone has, regarding nursing instructors. I made that clear in another post regarding nursing instructors, and this post just validates my beliefs. You should make a good nurse one day, in that you are learning to question early in the game. You may not be the most popular, but you won't be a blind hand maiden either. When in doubt, ask...never, ever, follow orders blindly. :)

Love767 · Apr 15, 2004

No need for an apology BabyRN2Be. I was simply pointing out that even if the scenario had been "imagined or borrowed from a book" that it wouldn't diminish the validity of the topic. It's like all of those "learning scenarios" that we have to do in class. I'm sure that many if not most of them are not actual scenarios (although some probably are, and all happen someplace on almost a daily basis), they are still useful for learning. I just wish they gave us a few points for the reports we have to do in order to answer them!

mattsmom81 · Apr 15, 2004

We all have our own consciences to answer to at the end of every day, as a wise poster alluded to several pages back. ITA with posters who point out that doctors and administrators are way too often more than happy to let the nurse carry the ball (and the liability). We must not be naive. I love attending nurse legal seminars and hear of how nurses lose their licenses; blindly accepting doctors and hospital's directives is one way.

My BNE has a Safe Harbor stipulation, where a nurse can say 'whoa' in a questionable situation and protect their license while an investigation is done. Yes this can cause a problem for the nurse too, (troublemaker) but it definitely opens up lines of communication.

BabyRN2Be · Apr 16, 2004

This thread bares alot of discussion, there are pros and cons to the subject as is the case in all ethical situations. I'm sure there was discussion at the hospital where this occurred. The student might not have been privy to all of it. But, along with ethical discussions comes professionalism. Please be careful about calling someone a moron.

Babinurse,

If you are referring to my post, I didn't call love767 a moron, not in the least bit. I was stating my opinion that I thought it might be a bogus situation. It was a concern of mind, and others said that the post had sounded "fishy." There was no disrespect intended, as I said I was voicing my concerns that this might have been left by a troll (which is now not the case) who wanted to stir something up and watch the ensuing chaos. It happens on here.

I wanted to state my opinion, NOT refer to someone as a moron.

If you weren't referring to me, I apologize.