Agitated terminal agitation or a hospice nurse's worst nightmare - page 2

by laynicrn 21,292 Views | 12 Comments

Yes, I meant for the title to read that way. Give a patient 10 mg versed, 15 mg haldol, 4 mg dilaudid, 4 mg ativan in two hours and they are still not only awake, but throwing things, hitting, screaming, trying to get up and... Read More


  1. 0
    i just have to say wow. im newer to hospice (only 1.5 years) and have never heard of anything like this. i agree it sounds like a drug interaction, see if the MD will evaluate 'all' her drugs. even ones she been on for years.
  2. 1
    there is the saying "we die as we lived" - in some cases may be if we did not finish our clean up jobs we cannot die in peace? and all the pain is partly emotional in origin....
    i had one patient who was alert and did not want pain medication, became more and more confused; out of bed, back to bed, into the wheel chair, back to bed..... the family was at his service and did what ever he requested; yes he wore them to a frazzle, and thankfully it was a large family so they could take turns; i felt badly for all involved BUT the daughter told me after he finally died that it was a great experience: the pt had seen other people in the ones that were present and had talked about different occurrences in his past and asked some for forgiveness for what he had done, others he just told old stories to them and on and on; after he was finished he settle and died; that family was grateful for not having used pain meds - go figure
    so yes, if that patient could work on her issues it would be the best, however.... if she is so resistant then she will have to die like she lived..... we all make our own choices
    when i first read the original post i had one thought: may be instead of all the meds we need an exorcist here?
    much prayer could not hurt! my prayers are with you who care for her!!!!
    leslie :-D likes this.
  3. 0
    We had a patient like that in oncology, the only thing that worked to calm the patient down was remifentanil(after giving the patient more medications to numb a moose).


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