Hospice morphine overdose

TriciaJ, RN · Apr 5, 2018

Robbie, if your post is legit then either you are working in hospice and don't understand what you see, or you have a family member on hospice and don't understand what you see. The hospice nurses will likely be very glad to explain anything to you that you don't understand, as long as you don't take the somewhat belligerent tone that's coming through here.

Otherwise, if you could tell us more specifically what you are referring to, many people on this site will be glad to help you understand things better.

Persephone Paige, ADN · Apr 5, 2018

*TRIGGERED*

My grandmothers both passed recently, one more peacefully than the other. Both were in Hospice at the end an my mother refusing to accept that my grandmother was not going to recover was the problem. The staff on every single occasion were always wonderful.

I don't think family understand what can happen if a person gets stuck in that place where they need to get their wings but their heart just will not stop beating. Hospice is such a gift, if patient families can accept that in most all cases, their family members are NOT going to make a comeback from this one. My mom made the nurses stop my grandmother's morphine so she could wake her up and ask her if she wanted a sandwich! The poor woman was 2nd and 3rd spacing and my mom was in complete denial. She wanted my grandma to live, my grandma was ready to go.

Watching how families flip out made me immediately ask for living will, advanced directives, etc... I also told my daughter that if she brought me up out of my morphine haze for a sandwich that I would kill her.

This problem is about the family's inability to process the inevitable death of a person who has met the requirements for Hospice placement. I guess because I have seen death in every way, I have witnessed people who are begging for death but it won't come, I get really upset when folks take issue with end of life morphine. Morphine is a really wonderful drug for breathing issues too, it helps to decrease the anxiety associated with shortness of breath.

chare · Apr 5, 2018

[...]
I'm starting to think Robbie might be a troll.

I don't think so. As TriciaJ suggested, I think that he's lost someone, either a family member or a patient that he was close to, and is trying to find answers. For some reason he doesn't feel that he can ask the hospice provider, so he has come here for answers, answers that we can't give him.

TriciaJ, RN · Apr 5, 2018

I don't think so. As TriciaJ suggested, I think that he's lost someone, either a family member or a patient that he was close to, and is trying to find answers. For some reason he doesn't feel that he can ask the hospice provider, so he has come here for answers, answers that we can't give him.

If he comes back and clarifies and continues the discussion, then we'll know the post is legit. His continued absence is starting to make me think he is a troll.

cardiacfreak, ADN · Apr 5, 2018

Robbie, if what chare says is true, please call the hospice provider. My hospice team has met with family members who were having a hard time dealing with the death of their loved ones. Hospice is just not about the patient, they care for the family too.

Mini2544, ASN, RN · Apr 10, 2018

Robbie- Can you let us all know what you think the definition of hospice is? What type of patient do you think is admitted into a hospice facility and why would they be a candidate for this type of service? I am just trying to gauge your understanding of all this.

Moon Magic · Apr 9, 2023

Okay just because you, yourself is 100% competent at your job that does not mean there are not bad apples. I found this article while doing research myself on the subject.
in 2009 my father was diagnosed with stage 4 lung cancer, he was outside tending his garden so he didn't want to accept the diagnosis but with my pushing him he went ahead and went to the cancer center for treatment. He was told to get the best treatment he needed a biopsy before chemo etc. He had the biopsy and the doctor accidentally punctured his lung. He was sent home and hospice was called in by the doctor for home visits. The following day a woman who was very cold towards us being there (we lived there mind you) and she kept going to his room and applying pain management (morphine patches) he was unconscious not moaning or making any indications of pain, within two hours of her arrival she applied 6 morphine patches, and he started to shaking, vomiting and gasping for air and then he was gone. The doctors had given him 6 months but he never lasted a day after that evil nurse overdosed him. To make matters worse we were so grief stricken we didn't even compute the crime at the time. It was later over a year later that the eight of us who were there and witnessed her remove 5 of the 6 patches before she called in the corner. They cleared and took all his medications and loaded his body and asked what funeral home we wanted. We each discussed the removal of those additional patches and I started researching what the dosage was etc and she clearly overdosed him.
I've struggled for the last 13 years with the guilt of his death and the circumstances surrounding it. I don't mean to just throw my personal story out here but the truth is some of them should not be hospice nurses. And again I will reiterate that not all of even the majority are this way but y'all don't get the nick name angels of death for nothing...Yano. Unless you're saying you hold yourself 100% accountable that no wrong doing is going on at every corner of every hospice, your actions do not reflect the entirety of all hospice workers. Both are opinions that seem to come from a place of hurt, as your offended as a good nurse and the op is offended by the actions of a bad nurse plain and simple. Emotions can make you do and say crazy things. I hope everyone is well and is healing.

JKL33 · Apr 11, 2023

Moon Magic said:

Both are opinions that seem to come from a place of hurt, as your offended as a good nurse and the op is offended by the actions of a bad nurse plain and simple.

It actually is not plain and simple as the OP never did disclose his or her position in regard to the post s/he made, and even if an accusation had been made, none of us would have access to any facts to back it up (or refute it, either way).

Of course no one can speak for every hospice nurse in the country.

Yes there are bad nurses. It's likely that some could be found in the hospice specialty just like every other specialty.

And families misunderstand many things, of no fault of their own.

But above all, I am sorry to hear that you have felt guilty all of this time. ? You were just trying to encourage your father to seek care for an illness that is deadly. You had no hand in his death. Although I can't apologize for another nurse's care, please accept my condolences and my sympathy that the end left your family with questions and suspicions and so much hurt.

Please take care ~

Tenebrae, BSN, RN · Apr 16, 2023

cardiacfreak said:

I'm starting to think Robbie might be a troll.

I think possibly robbie has had an experience that was crappy and traumatic for them.

Could be that I'm underestimating them and they really are a troll.

Morphine is one of the drugs that we use in hospice. If a person has impaired liver/renal function we often use fentanyl or oxycodone. Thats because the waste products from morphine are toxic and can cause more pain and discomfort.

Administering pain relief is only possible if thats how the doctor has charted it. There are too many checks and balances to just go giving morphine with gay abandon.

That said two patients on morphine may be relieving very different doses and neither is being under or over medicated. A patient who has been on morphine longer may be relieving a higher dose of morphine than the next patient who is only on a very small dose.

So Robbie, what happened and why do you think something dodgy happened?

No Stars In My Eyes · Apr 25, 2023

I knew a family that plastered their parent (who was having a truly awful time w/ the diagnoses, physically) with Fentanyl patches to help the patient (and themselves) on the way to an inevitable death. They were taking care of him at home with the help of hospice. They cancelled a night shift caregiver and did it that night.