I think it IS a wonderful program and I am so proud to be part of it.
We provide durable medical equipment related to making the patient comfortable (hospital bed, w/c, commode, oxygen, etc) as well as medications directly related to easing their symptoms (analgesics, anxiolytics, antinausea, bowel aides, etc) We know how the course of illness is likely to run and what things we are likely to need so we try to have the things we are going to need in place ahead of time to avoid stress and suffering.
We have a fairly extensive list of standing orders that were developed with and approved by our medical directors. At the time of admission the primary physician is asked to approve these standing orders. This gives our phone triage nurses and team nurses what they need to solve most problems immediately. We do use atropine but more often levsin for terminal secretions.
Analgesia is a whole topic in itself. On admission we do a thorough pain assessment. We use a 10 point pain scale and we look at location, duration and frequency, quality, and intensity of pain as well as accompanying factors. We use whatever works and is well tolerated by the patient. Frequently that is a form of long-acting morphine or duragesic patch with roxanol for breakthru pain. Oxycodone is also used often. Dilaudid is sometimes used when the others are not tolerated. Combination drugs, such as Vicodin, are usually appropriate when the patient needs temporary or occassional pain relief. Bone pain is often relieved with the addition of an NSAID. If there is a neuropathic pain component then a tricyclic antidepressant or gabapentin often helps.
Since we know that GI motility will be decreased by the narcotics we keep a close eye on bowel performance. Senokot or Senokot-S is our drug of choice for prevention. It is well tolerated and a wide margin of safety in dosage allows us to individualize treatment. If a patient was not on a bowel regimen previously that is what we usually start with.
Whew. I hope that answers all your questions!