I need advice and input, so here I am, at my most favorite place, with my most favorite nurses!
OKay, I have this patient and for hippaa reasons I won't get all the way into the dx and everything, but I will describe the situation.
I have a 40 yr old patient who has been taken care of by her parents for several years from a chronic condition. She still has her mind, but needs care 24hrs a day. Well, she's in my ICU for respiratory failure because her condition is progressive and chronic. From our conversations, the mother and father are in denial that this condition is going to eventually kill their daughter, when in fact this condition ALWAYS leads to death.
Now, the other day when the parents were gone, she asked me for pain medication. It was time for pain meds and she truley looked like she needed some. So I gave her a small dose and she slept soundly for a few hours. She much needed that sleep.
A few hours later one of my fellow nurses comes to me and tells me she forgot to tell me earlier that the father told her to tell me not to give ANY narcotics. That the patient would only get used to them and would lay there all drugged up and not get better. This is after I already gave the morphine THAT WAS ORDERED BY THE DOCTOR.
Anyway, I thought, okay, no big deal. The patient was asking for the medication, it is ordered, she looks like she needs it, and it's a small dose. No big deal.
Well, the dad comes to me and tells me I gave her narcotics and was not suppose to! He is very upset with me and wants to turn me in. I tried to tell him that she asked for it, the doctor ordered it,,, and the doctor even told me to give it because I had to call him. The patient's vital signs were indicating that she was in distress and the doctor wanted to give this med to help. I even documented this before I heard about this request from the father.
SO, my deal is,,, I understand they want to be in control of her health care decisions, but how far can they go?? Do they think she has no right to request her own pain medication? I think maybe this goes along with the fact that they are in denial of the chronic progressive aspect of this disease. They think that she will get better when no other person with this disease has EVER gotten better.
I just feel bad, and I don't know why. I know I did the right thing. I was not drugging her up, and she needed this narcotic for more than one reason.
I know that talking to these parents will not help. I tried to do that, but they wouldn't even let me say what I needed to say. They would interrupt me once they seen where I was going with the conversation.
I want to respect the parents, but I also have a duty to my patient. I just don't know what to say to these parents that will help them understand.