End of life policy hospice

heron, ASN, RN · Sep 24

Not sure what your question means. Are you asking about elective suicide? Please clarify.

NurseLsat · Sep 24

Yes its for washington state they call it death with dignity threw end of life washington. I'm looking for examples of hospice policies example hospice nurse may insert ng tube if needed for ingestion (or not depending on what your hospice facility policy says) do you have it written if nurses can be in the room when medication is ingested or not. How is your wording to incorporate level of participation and individual hospice nurses requirements vs optional needs.

FolksBtrippin, BSN, RN · Sep 30

My state allows MAID (medical aid in dying).
We don't insert NG tubes anymore for any reason due to guidelines that placement should be checked with imaging.

Our hospice policy follows the position of the ANA which is that no nurse should ever administer (illegal to do so anyway), that nurses can be present or not as they choose and cannot be forced to be in attendance by the employer or anyone else.

Jory, MSN, APRN, CNM · Oct 13

A feeding tube defeats the purpose of hospice and is an artificial sustainment of life unless, the patient had a medical reason, can ask for it, etc. Our hunger naturally goes away as we move through the process towards the end of life. Your body, also has reduced efficacy in digesting and absorbing nutrients optimally and peristalsis declines. Patients are typically told if the patient can ask for something to eat or drink and can safely swallow it, give it to them. If they are not asking, don't.

Tenebrae, BSN, RN · Oct 13

https://www.tewhatuora.govt.nz/health-services-and-programmes/assisted-dying-service/assisted-dying-information-for-the-public/information-on-assisted-dying-for-the-public#:~:text=Assisted dying became legally available,their life within six months.

This is my countries guidelines

NurseLsat · Oct 14

Jory- just to clarify the feeding tube is so the patient can self administer end of life medication to themselves when they can not easily swallow.

Tenebrae, BSN, RN · Oct 15

A patient who is end of life is unlikely to have the manual dexterity, motivation or inclination to self administer meds via a feeding tube

FolksBtrippin, BSN, RN · Oct 15

Tenebrae said:

A patient who is end of life is unlikely to have the manual dexterity, motivation or inclination to self administer meds via a feeding tube

Depends how we are defining "end of life". Patients with a 6 month prognosis can legally get MAID, and may be able to self administer meds through a tube, but I would not think that someone who can't swallow would be.
The reason for the tube is more likely about safety. They shouldn't be administered in a cup. There was a case where a man who was not intended to have the meds took a sip and required ICU.

NurseLsat · Oct 15

We have had 2 recent pts that had difficulty swallow so an ng tube was placed so the pts could self administere the death with dignity medications

FolksBtrippin, BSN, RN · Oct 15

NurseLsat said:

We have had 2 recent pts that had difficulty swallow so an ng tube was placed so the pts could self administere the death with dignity medications

Okay, what was the policy? Were you the case manager?

MAID is not part of hospice plan of care because our philosophy is to neither hasten death nor extend life. I don't think a hospice nurse should have to insert an NG tube for the purpose of administering meds to end life. But I think it should be up to the nurse.

NurseLsat · Oct 15

We are needing to update our policy- so this is why I am looking for hospice that have policies in place that can be reviewed- there seems to be a deference in thought for the ng tube amongst people- and while it has been discussed that nurses have the right individually to do or not to do... im looking for examples of policies.

. Just a note I am keeping my opinion off of this thread. But want to see and hear what policies other agencies do