morphine sulfate given even though has an "allergy" listed in chart

[NurseLoveJoy88]

I work in LTC and a resident has an "allergy" listed in chart to morphine sulfate. The resident was on hospice, actively dying so the MD prescribed morphine. My question is would this be considered a med error or bad practice for the nurse to administer this drug? Will this be a redflag to the state? If I was this residents nurse I would have clarified this with the MD and family. Sometimes residents/patient lists allergies that are not real allergies but are expected side effects. Or maybe the MD discussed the risks and benefits of drug with family. My concern is that NO clarification is documented in the chart. So what do you all think?

[lmwilsonrn]

Regarding the previous comment "they are dying so what does it matter?": this disturbed me a little, especially if this is coming from a nurse. Let's remember that our duty as nurses is to DO NO HARM! It shouldn't matter the type of patient we are dealing with. Nothing should be done that may cause more suffering for the patient than the dying process is already causing. This circumstance needs clarification with the MD. If it's not a true allergy but rather a side effect, another med needs to be given with it (ie benadryl, zofran or phenergan). There are also alternatives to morphine such as dilaudid.

[NurseSnarky]

I was getting a patient ready for surgery, and was going over her meds and allergies. She told me she was allergic to epinephrine. I asked her what happened when she had it, and she said, "It makes my heart race." I said, "OK."

I went over to the anesthesiologist and said, "Don't give Mrs. Jones epi." He said, "Why?" I said, "It makes her heart race." He said, "Man. I hate when that happens."

Did we have the same patient?! Just saw this TWICE over the past few weeks...said the same thing to the anesthesiologist.

I've also had patients that had morphine allergy and the reaction was listed as "acts goofy" or "loses mind". So itching isn't the only reaction patients will have.

[enchantmentdis, BSN, RN]

Pick up the phone and call the ordering doctor, clarify, then call the pharmacy, and document in the medical record that you did all of the above before giving any morphine. Also let family know morphine is being given. You know how family can behave.

[enchantmentdis, BSN, RN]

If the person is actively dying, what difference does it make?

:lol2: