Is everyone afraid to give Morphine?

CHATSDALE · Mar 21, 2007

most families that i have been in touch with will accept what will make their loed one comfortable

this seems like an unusal reaction..if you have more than one family over reacting maybe you should question the source of their misinformation

RN007 · Mar 25, 2007

I am an (older) RN student finishing up 100 hrs in a hospice rotation (and love it). I have not had any families hesitate over morphine. All of them wanted to see the pain alleviated. However, having said that, I work at night in an oncology unit and have nurses who do not want to give morphine to pts we have on the floor for comfort measures. I see lots of opportunities for teaching about palliative care to both families and nurses (and docs).

RNOCN2311 · Mar 31, 2007

Yes, it's common that they are afraid of morphine. To most patients and their families morphie is what drug addicts use. They fear it, and fear most pain meds at the start. I just tell them that it's better to control pain with meds than to suffer with pain. If you explain that they won't overdose if taken correctly and it's safe to use and it provides good pain relief it usually works.

Lorie P. · Mar 31, 2007

i find that if i explain to the family members that the morphine will help relax and ease their pain, that the pt doesn't have to work so hard to breath and it makes it easier for them to relax. i also explain that given in the right amount that their loved-one will not become addicted.

mosat of my pt's family's do not object after this and i have no problem easing a terminal pt's pain.

Mermaid · Apr 17, 2007

We give so much morphine and diluadid and marinol and ... that I am afraid that I have become very used to giving these drugs. We have some terminal patients who have built such a tolerance that they require such large doses of medication to get any effect at all. I have patients who take 12mg of diluadid Q 2hours.

txspadequeenRN, BSN, RN · Apr 17, 2007

it is not just the families but i have run into some nurses that do the same thing.....

rn-n- 2005 · Apr 17, 2007

When I first started I was a little afraid to give some of our patients so much at one time but now I have seen the pain some of them are in. Thank God for drips and PCA's!!

We don't have too much problems with families because they've seen their loved ones suffer.

The people with the most fear about giving Morphine, Dilaudid, Ativan, etc. are the float nurses from other specialty areas. They aren't used to the amount that we give and tend to undermedicate. They're the ones we educate the most.

sunnydaydream · Nov 16, 2007

Soon to be graduate nurse student here (December yay!), but I thought that I would put my two cents in... This past January my grandmother was dying and was in hospice, but she was being cared for at home. She had increasing symptoms of pain (looking back she was declining rapidly at the time though my mind was foggy and I didn't see it) and I was the one that was suppose to give her the first dose of morphine (oral). I wasn't afraid that I was going to kill her doing this, but as a nursing student and also being a CNA for 9years I knew that this was the beginning of the end (at least in this case) and emotionally I had a hard time dealing with it and the struggle of not wanting her to be in any pain. Granted, I gave her the medication, took care of her, and then scampered away to the bathroom each time to cry. About two weeks after my grandmother had passed away, in clinicals I took care of a patient end-stage cancer and in the dying process. He was moaning and in clear distress. I again had to give morphine. This time though my thoughts were clearer and I understood that this was something to help the patient and I didn't dread it as much as I did with my grandmother.

I'm sure that my reaction was affected by the fact that the first person was my grandmother, but I can see where families are hesitant about bring in "heavy drugs". I was able to help the patient's family understand the need for the morphine and they were more accepting with it. I think though that one thing that I always remember though is that in the back of many minds it's the beginning to the end and that's sometimes hard for anyone to grasp.

Rambling I know

psalm, RN · Nov 16, 2007

Too many family members would rather believe sensational articles in Reader's Digest or Ladies Home Journal instead of a medical or nursing professional. I had 2 fam members come at me like dobermans screaming "how much morphine are you giving her?!!". I showed them the MAR and the dose the doctor had ordered was 2 mg and they insisted I give her only 1mg. I got right down to the pt. and asked HER what her pain was on the pain scale 0-10. She told me it was 8/10. I asked her if the last morphine helped and what # on pain scale does her pain go down to and she said 6/10. I asked HER if she wanted the 2mg the doctor had ordered for her and she said "YES".

So I told them I would give the 2mg slowly, but we had to get her pain level to a more acceptable level, that 6/10 was not allowing pt. to rest, relax, get relief. When I checked on her 40 min. later she was resting, eyes closed. I touched her hand and asked how her pain was, it was much better, about 3-4/10. The poor dear was terminal, give her something for the pain!!

CoffeeRTC, BSN, RN · Nov 19, 2007

Had a heated discusion about this at work last night. Pt is ordered Diladid 10mg q 1 hr, Morphine 80mg q 1 hr SL and Duragesic patchs 400. Pt was taking at least 12 doses of the Dilaudid during the day. Wasn't getting any on the noc shift because the nurse was afraid????

hospicenurse MO LPN · Nov 20, 2007

I understand the attitude of using these drugs so frequently. But, think of them as "tools of the trade". I have seen pts take 40mg of Roxanol every 30 min (usually it is for dyspnea), 600 mcg of Duragesic and 8 mg of dilaudid q 1hr...I do understand that we "hand out these meds like candy" but, can you ONLY imagine what the quality of life would be if we DIDN'T advocate of these medications? That is how I think of it...