Morphine gtt/Comfort Care

[NurseyPoo7]

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?

[rngolfer53]

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?

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.

[NurseyPoo7]

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 home

She died a couple of hours after I left work that morning.

[Whispera, MSN, RN]

Warm wishes to you....

[rn/writer, RN]

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 home

She 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.

[Thanet]

My wife (RIP) was on massive dosages of morphine. She needed to be on them to stop the pain, otherwise she would just lay there and scream.

It is good to know that, at last, some nurses and docs are starting to understand the difference between addiction and pain control.