Quote from Love767
I don't know the trade name only that it was IV continuous infusion morphine at 2mg/hr with initial bolus of 10mg/, and optional additional bolus (I'm not sure how much). Is there a difference in action between trade names?
Our insturctor actually pushed the drug. She also explained that this is something that she has often seen, but which is just not talked about. She said it was something that was necessary, but which couldn't really be discussed very much because of the implications. The analogy she offered was that in our books it says that a patient is never to have a full set of bed rails without a doctors order (because it is considered a restraint) however, in practice if we didn't leave the bed rails up and a patient fell, we would be in big trouble.
That actually is not that high a dose of Morphine and probably wouldn't kill someone, even though it really depends on the patient and whether they had been taking opiates for a while.
It is a highly inappropriate assignment for a student, though.
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.
As far as the situation, we do "terminal weaning" from the vent, and use meds to ease the discomfort. And many of us give meds to patients in severe pain when it is clearly their wishes, despite some impaired BPs, if they are DNR and clearly terminal. But no one should be put in the position of doing something that goes clearly against their belief system.
I also have a problem with using MS to kill someone. Keeping them comfortable, preventing pain, even if it impairs some functions, fine but if there is no comfort issue indication, then it crosses a fine line into euthanasia. In terminal care, we frequently know that the drugs that we give for comfort, will probably contribute to the patient's death. But that is not the purpose that we use them. I've given a lot opiates, but I have and will never give them for the express purpose of euthanasia,
I think that the instructor has some 'splaing to do...