How fussy are you about O2?

[Vtachy1]

If a COPDer does not like his oxygen, and justifably asks "can you get too much oxygen". One night wife called in complaining that he was extremely short of breath, and the triage nurse said to increase the O2 to 3 liters. When I visit the next day he says it made him feel worse and before I even got in the door wife asks if a person can get too much oxygen because it made him feel worse.

I started him on morphine with great results, he takes valium for anxiety.

The next nurse visits him and pushes him to use that oxygen and he hates it. She orders a second O2 concentrator for his basement and wants him to wear it at all times.

I've always been taught that in Hospice the O2 is just for comfort and the morphine will actually help more.

[sapphire18]

Agree that the O2 should be about comfort only. And of course, in a COPDer, too much oxygen IS a bad thing, as it knocks out their drive to breathe and their CO2 will get wayyy too high. Morphine will help any feelings of air hunger.

[bestallaround, BSN, CNA, LPN, RN]

Where I come from, if a patient is Hospice, whatever makes the patient more comfortable, whether it is beneficial or even detrimental, that's what they get. If he were our patient and he did not want his oxygen, we would not make him wear it.

[tewdles, RN]

Ditto to the concept that the patient gets to decide what "comfort" means in their plan of care. If that means no O2 for the pt with pulmonary symptoms then I will have to be okay with that. We let them decide not to pursue other treatment without question, this is really no different.

[Meliss214]

What if the pt has lung cancer along with COPD, and prefers hi flow oxygen instead of high doses of morphine?

[SuesquatchRN, BSN, RN]

What if the pt has lung cancer along with COPD, and prefers hi flow oxygen instead of high doses of morphine?

I get an order for the O2 the way he wants it.

[Vtachy1]

Absolutely if its what the PATIENT wants. For sure! Just make sure its not what the NURSE wants. Good thing about Hospice is that the patient can to an extent sort of be treated the way he or she wants.

I'm so thankful the mentors in Hospice that trained me were not pushy about putting uncomfortable masks, and nasal canula oxygen on patients, but only if the patient wanted or said it helped.

[tewdles, RN]

Absolutely if its what the PATIENT wants. For sure! Just make sure its not what the NURSE wants. Good thing about Hospice is that the patient can to an extent sort of be treated the way he or she wants.

I'm so thankful the mentors in Hospice that trained me were not pushy about putting uncomfortable masks, and nasal canula oxygen on patients, but only if the patient wanted or said it helped.

I quoted you because I believe that the hospice patient can to almost every extent be treated the way he/she wants. Without trying to be exhaustive (it's late and I've had my scotch on the rocks) I would say that the patient can have the care/treatment they want unless it is contrary to hospice philosophy, illegal, or impractical for some reason.

Again, I'm certain that some clear thinking person can come up with a scenario that disproves the above statement. However, I think that the concept that the patient is the author of the hospice plan of care is sort of a universal hospice mindset.