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We have a comfort care/end of life set of orders at our hospital . I had a patient last night who was on this gtt - all day the nurse had kept her on 2mg/hr - when I got out of report, I went to assess the pt who had labored resp ... the morphine gtt had an order which states what to start the gtt at (usually 1mg/hr) and titrate PRN for discomfort/respiratory issues Q 15min - u can increase the gtt by the current dose + 25% of that dose. There is no "limit" set on the order sheet. Throughout the night she would have labored resp... pulse ox was always ok (usually 93-94% on NC). When day shift nurse came back I told her I had titrated the drip up to 8.5 and she could probably use another increase since she was starting to become labored again. Nurse looked @ me like I was a murderer and basically told me I was hastening this womans death.
Any advice on this? Is there something I am missing here? Whats the point of being on a morphine drip with titration orders if u arent going to use it?
Yes, the patient was on in patient hospice r/t CA which did not respond to treatment. Unfortunately she was young and had very young child at homeShe died a couple of hours after I left work that morning.
Because you understand something about pain management, you were able to make her last night on this earth a bit more bearable. You can be proud that you were able to offer such a gift. Wish that more would follow this fine example.
rngolfer53
681 Posts
I can't add much to what other nurses have said, except my praise to you for keeping your Pt comfortable, which was the purpose of the orders.
Good job.