Quote from TGood
A patient has a known overdose history for pain medication. She has since been put into a long term care program and receives pain managment both on a routine and prn basis. Her husband requested to give her the least amount of pain medication to keep her comfortable. She is constantly asking for medication. Is it wrong to inform her of her husbands request?
Are you honoring his request? If so, that's a problem. Her husband can request anything he wants, but unless she has been declared incompetent and he is her HPOA, his choices and preferences are immaterial. Her pain management schedule is between her, her doc(s) and her nurses.
Now, if you're asking if she should be made aware that he's making requests like this behind her back, I suppose that's a judgment call. You're not obligated to tell on him, and doing so might open a real can of worms between him and his wife. But you're the one in the thick of things, so it's up to you.
What you might want to consider is a social services consult to see if there are conflicts regarding her medication schedule that can be resolved. Or you may need to see if the husband understands the plan and how the meds are supposed to work. She might even need that, too. It's amazing how many patients and family members don't understand a lot of the basic concepts involving meds. They need to be taught about the differences between short- and long-acting meds, dependency vs. addiction, preventing pain vs. chasing it, etc. Loved ones are often opposed to narcotics for even severe, intractable pain because they haven't been properly educated (and they're not the ones feeling it!)
Back to your original question, when competent adults are involved, I really dislike behind-the-scenes finagling. I'm not saying such communication is never appropriate, but in this case it seems like he may trying to pull strings in his own way to offset her manipulative behavior. I'd think long and hard before getting in the middle of something like that.