Artificial feeding-Terri Schiavo

Nurses General Nursing

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I posted this here becaue I think this subject is something that we as nurses deal with on a regular basis.....Many many people state that they have a big problem with the feeding being stopped "allowing her to starve to death" The Vatican says " To starve her to death is pitiless" Most everyone agrees that it is one's right to refuse to initiate artificial feeding but somehow this situation "is different" How? The patient "starves to death " in both cases-so why has this one galvanized the WORLD? My husband read me a quote from the Bible -forgive me because I can't remember it in detail-it was something along the lines that a woman marries and leaves her father's house and her husband becomes her family....My husband is my POA I hope no-one in my family questions his motives -He KNOWS exactly what I want....I can't question her husbands motives-I know that some suspect foul play and state the results of a bone scan support this...That bone scan was obtained 53 months after she went into her coma-after her body suffered the effects of her eating disorders for a number of years.... Her present level of responsiveness does not pertain to this matter IMHO-she CAN'T eat naturally--she did not ever want to "be kept alive like that " and she can't state otherwise at this point...So- #1 can someone PLEASE make me see why this case is" DIFFERENT" and #2 How do YOU support your patients and their loved ones when they are agonizing over this decision? ONe thing I always ask is "Did your loved one ever give you any idea of what they would want if something like this happened" and if they did then I advocate that stance for that pt as much possible.......I believe that death is the last great trip we'll go on and we should PLAN it as much as possible.The greatest GIFT we can give to our loved ones is an itinerary...........

Teapot, I certainly didn't mean to imply that when I said "someone up North" (don't know where that came from), that you or anyone else was criticizing the South.

But I have to believe, I mean I really have to believe, that our ME is on the up and up, legit and competent. I can't fathom anything else, it's too frightening.

I do not have a problem with a witness or even a second opinion, but I have a problem with that expert being hand picked by the Schindlers, no matter how good he/she is. No offense intended to the guy from "up north". :)

The bottom line is that we will probably never know if Michael S. did anything violent towards his wife. If I had the money I would offer him a million to take the polygraph (in fact I will write Glenn Beck in an attempt to get him to start a new fund drive for that purpose). I think there was reasonable doubt as to whether or not Mrs. Schiavo was PVS or minimally concious. Not only do we have the testimony of previous nurses who cared for her, but we also have over thirty M.D's who signed affidavits to that effect. Again, if she couldn't feel pain (as was the contention of the pro-death people) then why give morphine?

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
The bottom line is that we will probably never know if Michael S. did anything violent towards his wife. If I had the money I would offer him a million to take the polygraph (in fact I will write Glenn Beck in an attempt to get him to start a new fund drive for that purpose). I think there was reasonable doubt as to whether or not Mrs. Schiavo was PVS or minimally concious. Not only do we have the testimony of previous nurses who cared for her, but we also have over thirty M.D's who signed affidavits to that effect. Again, if she couldn't feel pain (as was the contention of the pro-death people) then why give morphine?

I still won't let my spouse or parents live in a "minimally conscious" state if that's what it is.

If 30 MDs said she wasn't in a PVS and responsive, then the laws of Florida were broken, as I understand them. Wonder why this wasn't caught?

I certainly can't speculate whether or not he abused her or not. Sounds like he fit the profile. I guess no ER records have surfaced. I would think several skull fractures might have sent her to the ER at least once.

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MSO4 is given for a variety of reasons besides pain.

Attempts were made to move TS from the hospice facility to an ECF, but no one was willing to accept her. What would you have had them do, turn her out in the street?

I had heard that although TS was in a hospice facility, she was not under the hospice benefit, meaning she was being billed under a different coverage (perhaps skilled care or even private pay). Since none of us have seen the bills, it's hard to say.

And as a former hospice nurse, I have seen pts on the hospice benefit for longer than a year; as someone else said, the pt. has to be recertified and show decline. I've done many of those assessments, and they have stringent guidelines you have to follow to recert someone.

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Contrary to popular belief, if the feeding tube was removed she would not starve to death but die of dehydration. Dehydration is a peaceful and painless death.I did a hugh research paper on this subject and people are misinformed.

THATS TRUE DEHYDRATION IS THE BEST WAY TO DIE. SOMETIMES ITS HARD TO GET PEOPLE TO UNDERSTAND THAT. I HAVE TO WONDER SOMETIMES HOW MUCH MEDICAL INTERVENTION INTERFERS WITH OR CHEATS DEATH. JUST BECAUSE WE'RE ABLE TO KEEP PEOPLE ALIVE SHOULD WE?

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MSO4 is given for a variety of reasons besides pain.

And as a former hospice nurse, I have seen pts on the hospice benefit for longer than a year; as someone else said, the pt. has to be recertified and show decline. I've done many of those assessments, and they have stringent guidelines you have to follow to recert someone.

Thank you, nicely put. That is what I was trying to get at in a earlier post.

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Medicaid could have been paying for the daily expenses. Like I said it may be different with a inpatient hospice.

WHEN WE WORK WITH HOSPICE IN LTC MEDICARE PAYS HOSPICE FOR MED/NURSING AND MEDICAID PAYS ROOM AND BOARD

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WHEN WE WORK WITH HOSPICE IN LTC MEDICARE PAYS HOSPICE FOR MED/NURSING AND MEDICAID PAYS ROOM AND BOARD

LTC is different from inpatient hospice. Unless when you say LTC you are meaning inpatient hospice.

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The bottom line is that we will probably never know if Michael S. did anything violent towards his wife. If I had the money I would offer him a million to take the polygraph (in fact I will write Glenn Beck in an attempt to get him to start a new fund drive for that purpose). I think there was reasonable doubt as to whether or not Mrs. Schiavo was PVS or minimally concious. Not only do we have the testimony of previous nurses who cared for her, but we also have over thirty M.D's who signed affidavits to that effect. Again, if she couldn't feel pain (as was the contention of the pro-death people) then why give morphine?

To be fair, not only the husband, but the nurse (one nurse) and the aids who did the affidavits should take the polygraph test (since those are serious charges). So you'll need about 4 millions (1 for the husband, 3 for the nurse and the 2 aids).

As whether Terri is PVS or not, it really depends what you look at. If you look at the CAT scan, you don't need to be med student to see the huge extensive damage. If you look at video clips on the parents site, it would look like she is not PVS. But if you look at clips from a 4 hour (the link to this is burried in one of the 700+ messages) video, Terri does look like she is PVS. It really depends what clips you look at.

I personally looked at the clips again at the parents site and think more critically about it last night. I decided to play's the devil's avocate and assumed the people who did the clips on the parent's site has bad intention and here is what I come up with:

* "Terri and her mother" - Notice there are no response when the mom first walk in and speak to her. Notice her eyes does not track her mom UNTIL her mom touches her. Also the noises she made is AFTER she is being touch and move. Could that be what other docs call a reflex reaction since a PVS person do have reflexes.

* "Swab Test" - Again she is reacting to touch as a reflect which is within the scope of PVS.

* "Terri Response to Music" - First of all, her reaction actually looked like she hated the music and her mom (I assume) ask if she liked it. That kind of grunt, we have no idea if it is due to the music or not. Does she do this when there are no music?

* "Tracking Balloon" - Whoever took this clip did a lousy job. If you look carefully, you will notice we never did see Terry tracked the balloon. All we saw was her eyes move to the side and back and so on. What they should have done is not a close-up of Terry, but zoom out so we can see the balloon. That way, we have no doubt whether Terry is tracking the balloon. Hmmmm... are the person doing the filming trying to hide something... I mean, they did zoom out once where the doc is holding the balloon on the left side and they zoomed in and you see Terry's eye is actually looking on the right side (Terry is not tracking). You have to stop the video and play it since it is fast.

* "How's your cold" - Again, could this be just reflexes. I mean this clip is extremely short. It would be a lot more convincing if the clip is a lot longer. Why do they make so short?

* "Asked to open her eyes" - I am commenting on this one last because I think this is the most powerful clip they had. This is the clip that at one point pulled me over to the parent side. But let's be real objective and ask some hard questions. First, notice Terri did not respond at all when the doc (?) ask Terri to open her eyes. She did open her eyes with the eyebrow going up later. But could that be just because she is reacting (yes, reflex again) to something in front of her (the doc or the doc is doing something to catch her attention) and has nothing to do with the voice request. Also what is disturbing is at the end, the doc asked Terry to close her eyes and we are cut off. We never see Terri respond to the request to close her eyes or not. It is reasonable to assume that she did not close her eyes and that is why they cut it off.

Personally, I would like to see the full 4 hours clip they had.

Notice another thing, who did most of the mud slinging? The parent's side. The husband remained relatively quiet while he is being condemed. Couple times he did lashed out but wouldn't we all if we are being accused of these things falsely?

As for morphine, I am no expert at it. But I do know that in hospise, sometimes they will give meds to dying patients for the sake of the family who is watching as the body is at the last stage of shutting down even though the patient probably are out already. Espeically if the family have not seen death before and they don't understand/experience watching someone die. Beside pain, isn't morphine sometimes given also to reduce fluid seepage into lung tissue or something like that which I asume can make the patient breath easier (I am probably totally wrong in this, someone who knows please correct). Guess we have to ask the hospice staff at Terri's why, but we don't have that luxuary.

-Dan

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As I said before, I am not trying to change your mind about what you believe, Roland. I'm just trying to comprehend all of the things you're saying outright as well as implying.

So let me make the attempt to restate what you've already said:

You believe that Mike Schiavo attempted to murder his wife and ultimately prevailed and succeeded. He was that much smarter than all those investigators, yet so much sicker psychologically than we imagine. He has been under close scrutiny at his job, in his schooling, visiting his wife, and at his home over the past 15 years, but he was so much more clever than all those people?

You're certainly entitled to your opinion.

You imply that corruption in Hospice, the courts, the governor's office, the police, the hospital ER, the legislature and in the Medical Examiner's office caused the facts of the case to be completely disregarded.

Quite a stretch, even if you're really cynical about authority. Though I sincerely think you owe us Floridians an apology, just on general principles, after having bashed nearly all of our institutions.

You believe that Terri Schiavo was able to take in food and water by mouth, based on the medical expertise (or unrealistic hopes) of her parents. When she hadn't eaten or drunk anything in 15 years. When in fact, had anyone succeeded in giving her that symbolic glass of water that those children were arrested trying to serve, she would probably have then died from aspiration pneumonia.

But back to what you've been saying: Have I got it right, or did I miss anything?

In short, you feel that the law failed Terri and her family because she didn't die the way you approve of morally. Which made you angry enough to spew false accusations and speculate negatively about everyone even remotely connected to this case.

Is that what your posts are really all about at this point?

Because it does look that way from this corner.

And if that is truly the way you feel, I can respect that. But you need to understand that you are saying some things that are sounding a little farfetched at this point, IMO, and I hope you can understand and respect the rest of us by refraining from accusing all those people of conspiring to kill an innocent person.

OK?

Very well stated!

I've seen so many accusations about Michael attempting to kill Terri, it's laughable. One would have to be able to outwit a lot of people in what has been a highly energized and media driven situation for the last 12 years or so. Like the "M.D." on this website http://codeblueblog.blogs.com/codeblueblog/ who claims as a radiologist, that the CT scan from miami.edu shows a shunt, but discounts that fact she had a DBS implanted early on. He only mentions it as if it can't be the implant. Wrong! She had one DBS inserted, most likely in her thalamic region, however, the wires from such devices follow that path to the surface of the cerebrum. Most of these reports are coming from certain websites that clearly have an agenda. I've read the actual information from her original discharge along with many other documents actually verified to be legal record, and in no way is anything indicative of attempted murder on the morning of 2-25-90.

Everyone just wants to blame Michael Schiavo for this or that because he's proven to be a person with low moral standards, but no one has even begun to question the parents in all of this. Terri Schiavo was said to have bulimia, so it is very possible that her parents were responsible for this disorder. Also, now that Terri has passed away, the Schindlers are selling private information on those who donated to their cause to a telemarketing firm. Real nice, eh?

The Schindler attorneys are also just as bad in how they conducted their affairs though the proceedings. One late appeal I read stated that the previous ruling to deny reinsertion of the feeding tube was a "Death Order". That's the way to win over the court.

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Specializes in Medsurg, Rehab, LTC, Instructor, Hospice.

http://www.theempirejournal.com/0311051_schiavo_attorney_felos_n.htm

Especially check out the information about medicare fraud.

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http://www.theempirejournal.com/0311051_schiavo_attorney_felos_n.htm

Especially check out the information about medicare fraud.

http://www.sptimes.com/2005/04/02/Tampabay/Routine_returns_a_sen.shtml

Hopefully this one will balance it out a bit.

There are some real nasty sites out there calling the hospise staff all kinds of names from being stupid to murderer.

-Dan

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Specializes in Medsurg, Rehab, LTC, Instructor, Hospice.
http://www.sptimes.com/2005/04/02/Tampabay/Routine_returns_a_sen.shtml

Hopefully this one will balance it out a bit.

There are some real nasty sites out there calling the hospise staff all kinds of names from being stupid to murderer.

-Dan

Thanks for the great article. We need balance in these times of high emotion.

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