Neuro ICU - Withdrawl of life support...is this so wrong?

I was not involved in this but, heard about it when I came in on Sunday. This patient was having life support withdrawn, and the CCP pushed 300mg of fentanyl, after extubation...he of course died within minutes. Now that could be considered euthenasia. (none of the nurses would push that amount, hence the doc did.)

I think you are a kind and compassionate person and I would want you to take care of me when my times comes.

Keep them comfortable even if it does mean hastening their death (and I'm not saying this did).

FYI OP, I think you did right too. Not a prob here. Some people in nursing wouldn't see it that way.

Double check this but I'm pretty sure that per FDA only a CRNA or MDA can use propofol on a non-intubated patient. As I'm sure you are all aware, we as RN's can't push propofol for conscious sedation. I ran into this situation a few years back: the doc wanted propofol for conscious sedation & it was a big to-do, resulting in a CRNA being at bedside to do so. The PharmD stated that it was because RN's can only use propofol on patients who have protected airways because it is an induction agent. I'm not sure if it was just our hospital policy or if he was correct so double check.

The use of Diprivan is seen more and more in palliative care, especially in oncology, therefore, on non-intubated patients. It's used for conscious sedation with patients who respond poorly to benzo, or as a treatment for severe nausea and vomiting. As for who can or cannot give Diprivan to a non-intubated patient, I suggest you double-check. In my facility, we can, but its not in USA. We often have a Diprivan perf for our non-intubated patients, to be titrated according to a prescribed RASS score.
IMO, I think you did right !

Could it have been for the comfort of the family rather than the comfort of teh patient?

I am a new grad nurse. I have not seen someone removed from life support yet. I had no idea that this could happen (meaning the patient struggles). I am thankful for the article because it taught me something. I hope that you will go on and continue your nursing career, like everyone else has said, you will know how to prepare other families and now, thanks to you, so will I.

When in the situation of a terminal dying human, most are not comfortable. We at times avoid the room, do the q 1 hour turn and assessment, look at the family gathered around the bedside and offer words of comfort some how. We have all the tools we need to allay suffering. we know the outcome, yet we are never ready. I have pushed more morphine Diprovan ativan inapsine than a narc box can hold and until the soul/spirit is ready to leave the body, will death occur. just my observations of watching the last breath sitting at bedside and being there with the families. I have seen patients receive ungodly amounts of the above and none have taken their last breath while large doses of morphine was pushed. Many refused to die till they were good and ready... till a wedding was over, and the bride and groom came to their room, till the day of their pension would go into effect so their spouse could get benefits, till a brother sister mother father made it to the bedside. We give so much credit to ourselves and the medications we administer. We tear each other down with out seeing the whole picture. You have to live with yourself and your actions. Be true to yourself. Just remember the spirit is strong even though the shell is weak. Slow down and hold their hand talk softly and don't be afraid of the dying, don't be afraid to give the medication to keep them out of pain, physical or mental. That is what being a nurse is. relieving fear, pain and anxiety and helping one die with dignity. NurseCutie it sounds like you have insight and concern for your patients. Asking 4 opinions will get you many.