"Ditto" to ilovelilac for her thoughts-I agree w/ them all. I've been in hospice for awhile now, and find that its really easy to get complacent, and settle on 'that' med for 'that' symptom; why?-because it worked in the past? We need to continue to challenge ourselves, as that kind of thinking can lead to burnout and stagnation(needless to say, its not the best problem-solving technique, either!). As nursing fights for respect among other professionals and the public, it really helps my credibility with physicians, and my TEACHING to my patients to be able to give a good, confident, and concrete rationale; not one that I or somebody else 'tried'- that worked before. Our patients deserve-and we can give-more than that. We've begun to have regular inservices by hospice pharmacists about routine, palliative care, and off-label uses for varying medications. I feel strongly that even though patients no longer want aggressive care for their illness, they do deserve the best palliation of their symptoms that is possible.