Need advice, please

  1. I have a friend with advanced ovarian cancer. She is 40, and it is reportedly spread to her pancreas and liver. She is being seen by an oncologist and is receiving Doxil (sp? I think) chemo qmonthly. She is fighting bouts of recurrent nausea. Losing weight. Fighting dehydration. Very supportive husband. At times she becomes so dehydrated that she needs to go to the hospital for IV fluid replacement. Othertimes, she develops ascites and has to have the excess fluid tapped.
    Her husband wants me to come by and check on her when I can and recommend when the dehydration is severe enough to warrent going to the hospital. Never having had any experience with home health or with oncology, what sort of parameters should I look for in knowing when she should go in for fluids? By the way, it has been suggested that she get a PICC line, rather than keep getting peripheral IV's put in over and over. Any suggestions that you give will be most appreciated and I will pass on to her.
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  2. 6 Comments

  3. by   catlady
    Very sad situation, and of course, as a friend, you want to do everything you can. But as a nurse who wants to keep her license, and as a nurse who wants her dear friend to receive the best possible care, you should refer them to an appropriate home care agency, perhaps hospice, so they can receive services from a nurse who is trained to care for patients such as your friend. This would really be best, both for your friend, and for your license.
  4. by   Jay Levan
    I see no problem in helping a friend who reqests your help. Problems arise when the definition of "Friend" is diferent for the parties concerned. If both parties consider each other with the same definition, then you may offer advice, "I would do this or that, if I were you" etc. For dehydration parameters, serum values, fluid volume values etc. I would ask those questions here in the form of "Search" in this sites browser. Hope this helps you in your quest to help your friend. My prayers are with you both.
  5. by   traumaRUs
    What a very tough situation. I have to go with the "giving medical advice to friends isn't good advice" group. Referring to hospice or home health will give you the latitude to be friends and help that way. By giving medical advice, you are possibly crossing the line. Prayers and thoughts with you.
  6. by   SKM-NURSIEPOOH
    wow...this is very, very sad. i also have to agree with everyone else's advice regarding offering medical advice to your friend. i sincerely believe referring your friend to hospice care would really help everyone in the end.

    my heart goes out to you, your friend, & her family. i'll remember you all in my thoughts & prayers too.
    originally posted by traumarus
    what a very tough situation. i have to go with the "giving medical advice to friends isn't good advice" group. referring to hospice or home health will give you the latitude to be friends and help that way. by giving medical advice, you are possibly crossing the line. prayers and thoughts with you.
  7. by   ceecel.dee
    A port or PICC line would be a great/necessary thing for her.

    It seems to me that the pt herself would be able to gauge best when she feels poorly enough to go in. Orthostatic BP's and HR are noninvasive and helpful. Be careful about advising.
  8. by   fedupnurse
    Got to say I agree with all of the above. I just went thru a similar situation at work with a doctor dying of cancer. It ripped our unit apart. All of us went to this man for any cardiac type work up that we or our families needed. It was very, very hard on all of us to watch this very head strong confident man become a shadow of his former self. Your friend definetly should have a port for her chemo and if need be she should also get a more permanent IV access. She should really be thinking about a hospice type program. I think people fear that means they are giving up but the quality of life people in hospice have is far better than those who are constantly in and out of the hospital setting!
    I wish you and your friend the very best and hope her remaining time will be quality time and spent with those she loves.
    Take care of yourself during this time too.

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