Originally Posted by aprilleverett OK.. i have wondered this since i was an aide... i totally agree that euthanization is wrong.. but in a way we do it often.. in LTC.. especially those on hospice we give res so much morphine and ativan scheduled.. .25 to .5 roxanol q hour sometimes that they die much quicker... now i agree in quality over quantity but.. why do they schedule roxanol and stuff? why couldn't it be q 1 hr PRN for s/s pain or discomfort? I always am leery of giving so much roxanol to a dying patient any opinions?
hi april,
first and foremost, we do
NOT perform euthanasia-euthanasia's
intent is to assist someone in dying.
in hospice, the intent of adminstering mso4 is to relieve pain or prevent it.
big, big difference.
most md's will set parameters for mso4, such as hold for rr < 8.
others will not even set parameters.
i've also encountered too many md's that order mso4 et al, prn only.
many times that is frustrating as there are many nurses that hesitate to give mso4, such as yourself.
if you think a pt. is getting too much where s/he is literally snowed, you can always withhold the med, circle it and write on the back why it was held. but you need to also let the md know that you held it.
in my experience as a hospice nurse, there have been more md's that prescribe a controlled substance only on a prn basis.
but i reiterate, in euthanasia, you are actively assisting in suicide.
in hospice/end of life care, you are controlling/preventing pain.
it all comes down to intent.
much luck to you.
leslie
Morphine/ativan cocktail
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