A hospice patient at the LTC I work at requested a cigarette which was held in our med cart. Why not? It's not like he'll acquire bladder cancer (he's already got it, the end-stage form!) from smoking another cigarette. So, I gave it to him under the condition that he smokes outside in a designated smoking area. He was very compliant, a very nice patient. The nurse working with me the next day had that patient and asked me, did the patient an order for the cigarettes?
...Really? The man is in pain, anxious, and dying, and the nurse really needs an order to let him have his cigarette? I don't smoke, but I don't care. This man knows he's going soon. Why withold the things that relieve his anxiety about dying, over an extremely trivial "order." If you're really uncomfortable giving him the cigarette, get the damn order!
Another resident on hospice wasn't putting out urine during my shift, but with no complaints of discomfort, and the relief nurse asked, did you call the doctor? ... What's the doctor supposed to do, order lasix? Order an in/out foley cath? Would an elderly woman want to spread her legs so a stranger can put a tube in her privates? That's the last thing she cares about.
Geez. I get really ticked off when some nurses don't think. I feel like at my LTC there's so much ignorance about hospice and comfort care. Liability preceeds every thought, every action, I feel terrible for the hospice patients here when the nurse don't use their humanity to think.
