Turning a hospice patient in severe pain? - page 3

I am seeking the opinions and advice of some of you experienced hospice nurses :) I work nights in an ICU, and occasionally care for patients who, during their ICU stay, are changed to comfort care only and stay with us until we... Read More

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    I'm sorry for your loss. It sounds like you did the most compassionate thing. Have you heard of a Kennedy Ulcer? They develop quite rapidly at or near the end of life despite all sorts of interventions.

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    I know they explained they could develop. I watched his heels meticulously and all other boney prominences. I even insisted on removing his socks to his wife's dismay because his fever spiked at 106.9 at the end. I was afraid of him seizing on top of everything else in front of them. And oddly enough, him seizing wasn't near as concerning as him being in pain to me. But we watched him suffer extensively until the pain drove him crazy and were all one request away from giving him the gun he begged for. So the pressure sore, was tough for me to witness. I thought the Kennedy Ulcer started dark, almost levidity looking. This was reddened and a giant blister that ripped open as soon as the aide touched it to roll him. I instinctively moved her hand away and stood guard over his hip while she washed his body. Not sure why. He was dead, an didn't care at that point.

    I don't know if it was because it was him and I loved him like a father, or Hospice in itself. I realized that Hospice nurses are a special entity and that I don't believe I have the emotional stamina to do that when I get done with school. Our nurse was excellent. She was a master at talking to me on a more medical level because she knew I understood it, but to the rest of the family dumbed things down significantly, giving them what they needed to know, in terms they could understand.

    But all that to say, OP, it was a tough situation. You were in a position where protocol demands you maintain skin integrity. Where, this patient had more pressing needs. You did they best you could with what you had to work with.
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    Just a side note, hospice does not put people into coma's with morphine as they near death. Change in level of consciousness is expected and might be exacerbated by the morphine, but the morphine did not cause it.
    leslie :-D likes this.
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    Thanks for that info. Reasons why I am a nursing zygote. I still have much to learn. I do know it does make people sleepy. That's what I referred to. Thanks for the correction.
    tewdles likes this.

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