assisted suicide

If the patient is requiring MSO4 routinely for breakthrough pain, perhaps it would be appropriate to request the MD to look at the amount of MSO4 the patient receives over a 24hr period and change the ATC pain management to MS Contin or a Duragesic patch. Tylenol by itself as a base with Roxanol as a prn seems unusual to me.

yes me too, that's what the hospice nurse ordered. I'm going to see what else could be done.

Can the resident verbalize his wishes?

Is there a reason why she thinks he is miserable? Maybe you can address that.

As in suicide cases, if she really wants it done she will figure out a way on her own, otherwise it's comfort care all the way, and giving her as much support as you can to get through this hard time.

I have a resident that is on hospice and morphine prn and scheduled Tylenol and Ativan. I try my best to keep him comfy and pain free as best I can while following doc orders but the wife insists that we give him more and more morphine so he can pass away and be put out of misery.

is the resident truly in "misery"?

like canoehead asked, what makes her think that?

re comfort care, i do believe the doc has it backwards...

where it should be scheduled mso4 and ativan, with tylenol as the prn.

you or the don, should advocate for a change in orders so he gets the mso4 atc.

and you might want to slip one of those ativans, to the wife.

leslie

While I am an advocate for legalizing assisted suicide, that's a different topic for a different day.

You stated in your post that the wife wants more and more MSO4 to put him out of his misery. So this does not sound like a pain motivated request - or even a thinly veiled pain related request for that matter. It sounds like you have a good relationship with the wife. Take a moment when she asks you to bump up the morphine so he can go peacefully to explain that you don't want to see him linger and suffer either, but that you can't violate your orders and break the law either. You can try to be funny about it by saying that she'd have to agree to bust you out of prison later.

I agree with the other posters - that morphine should be RTC and the tylenol PRN - or switch it up to the patch like also stated.

thanks for the replies. Upon my assessment he is in pain. He grimaces and thrash and clenched his fist. he may can use mso4 Rtc.

Up that morphine- definitely.