My best friend in nursing school was ordered to terminally sedate a stroke patient.

Blackcat99 · Apr 12, 2004

:angryfire :angryfire :angryfire You're absolutely right Psychrn03!

Why are we wasting good morphine on that worthless SOB! A slow agonizing death would have been much more appropriate. I hate child molesters and yes I am very happy when I hear of a dead child molester.

sbic56, BSN, RN · Apr 12, 2004

:angryfire :angryfire :angryfire You're absolutely right Psychrn03!
Why are we wasting good morphine on that worthless SOB! A slow agonizing death would have been much more appropriate. I hate child molesters and yes I am very happy when I hear of a dead child molester.

Whoa...you were serious! As long as you are merely using this board as a way to vent and would not practice with the venom you so obviously feel toward this group of people, I suppose no real harm done. But, it would behoove you to be careful; remember that as a nurse, you have been entrusted in giving approprite care to all your patients, leaving your judgments and biases at the door.

CCU NRS · Apr 12, 2004

caroladybelle
I was not so sure there was no suffering. I'd rather give it and be sure the patient was pain free than not give it and risk the terminal patient being in pain of any kind if I could make it otherwise. Kind of goes along with the idea that we know people can feel pain in their sleep, thus we medicate, so why not in a "comatose" state? The OP said nothing about what the patient was dying of, only that they were terminal. It is my job to ease the end of life; if it means shortening it a little in the process, I can live with that, too. I'm not quite sure who you meant was the wimp, the nurse or the patient, but at any rate I disagree with this statement totally:

To me the points are that a student was asked to perform this task with an instructor saying it happens all the time, which may or may not be true but it is as far as I am concerned left up to each nurse to make these decisions I will not give a lethal dose and I wil not ive any dose if as mentioned there are no S/S of pain/distress

OP He was comatose and given little chance of recovery (but was breathing on his own). His family wanted nothing to do with the guy because they said he was a child molestor. A medical review board at the hospital made the decision. Here's what bothers me. My friend was ordered to give 2mg/hr IV. (as needed), but told that he would need the medication every hour. Our instructor said that this will kill most patients within a couple of days, and that respirtory depression wasn't "such a bad way to go". She said that this is done in hospitals everywhere only it's just not called what it is. I'm not sure how I feel about euthanasia (there are good arguments on both sides), but the point is that I thought that it was currently illegal in the United States. Is this true or is my instructor just wrong about this dose killing most people within a few days? If it is true is this really common or what? Seems like an attempt to implement a policy (euthanasia) without a public debate on the issue.:

It is euthanasia if the Pt dies one minute before they would have with out intervention and a Morphine drip of 2mg hr continuous will eventually build up to a dose that is not safe.

CCU NRS · Apr 12, 2004

The original post was

: For crying out loud people the patient was a child molester! If someone kills a child molester that's a good thing! I wish I could have been the one giving him the drug. What's wrong folks Don't we have enough child molester's already! What a lucky student to be able to do such a wonderful service for humanity! :

This is dangerous thinking in my point of view and shows considerable mental anguish and possibly a need for psychiatric intervention, especially if you were molested and have not gotten help and even more certainly if you were not molested but have famly or friends that were and are carrying this type of hatred and anger over this issue. I do have experience with molestation I am a father to two step daughter who were molested by their bio father and I left it to God and the man is now going to die in prison he was sentenced to 60 year without parole and I am also certain that his prison time will not be without torture, I do not hate him I pity him most molestors were moleted themselves but he will surely die in prison and probabbly after being used badly by others in that situation.

:angryfire :angryfire :angryfire You're absolutely right Psychrn03!
Why are we wasting good morphine on that worthless SOB! A slow agonizing death would have been much more appropriate. I hate child molesters and yes I am very happy when I hear of a dead child molester.

The continuation of you hatred and anger gives me much reason for concern, you seem to be a very concientious person in other posts i have seen you reply to so I would just ask you to seek assistance with the issue you have over this particular issue, I wish you the best of luck in finding peace. I will leave you with one thought Charles Cullen and many others like him thought/felt they were doing the right thing as well, It is a dangerous trap to get into thinking you should decide who lives and who dies.

http://news.bbc.co.uk/1/hi/world/americas/521904.stm

http://www.itechnology.co.za/index.php?click_id=3&art_id=qw1032460201629B253&set_id=1

http://www.nursingadvocacy.org/news/2003dec16_nyt.html

happystudent, RN · Apr 12, 2004

Just wanted to add my 2cents....

I respectfully disagree c/ those who feel that this was an inappropriate pt to be assigned to a student. I ve been assigned to pts that were on the verge of coding, or extreme hypertension and I was pushing lopressor and vasotec c/ supervision from my instructor. I think situations like this enhances our learning experience and makes (me) reflect on my own abilities and ethics. To shelter one from "unusual situations" denies that person the opportunity to learn how to work in certian situations.

Now, I could see if the "student" was uncomfortable, but I DEFINATELY feel that students should be exposed to as much as possible in the little time we have. Don't shelter us............please.........

As for the instuctor, maybe she/he should of clarified what was really happening and followed up in post conference........

CCU NRS · Apr 12, 2004

Just wanted to add my 2cents....
I respectfully disagree c/ those who feel that this was an inappropriate pt to be assigned to a student. I ve been assigned to pts that were on the verge of coding, or extreme hypertension and I was pushing lopressor and vasotec c/ supervision from my instructor. I think situations like this enhances our learning experience and makes (me) reflect on my own abilities and ethics. To shelter one from "unusual situations" denies that person the opportunity to learn how to work in certian situations.
Now, I could see if the "student" was uncomfortable, but I DEFINATELY feel that students should be exposed to as much as possible in the little time we have. Don't shelter us............please.........
As for the instuctor, maybe she/he should of clarified what was really happening and followed up in post conference........

I feel that the instructor has put a student into a potentially culpable situation and put the entire case in even greater jepordy by having a student perform in a very questionable manner, for one thing the order did not even seem to bew clear from the way I read the OP something about "Here's what bothers me. My friend was ordered to give 2mg/hr IV. (as needed), but told that he would need the medication every hour." as needed would indicate nursing judgement but then someone was telling this person that it was needed every hour, I think this instructor did a disservice to the student by #1 involving him/her in the situation and #2 telling him/her that this is how things are done #3 Not allowing room for nursing judgement and a correct assessment to decide if Pain medication is actually appropriate or needed. I let students in y facility do anything they are capapble and have been trained to do but this instructor IMO was just providing added probelems to an already sticky situation.

happystudent, RN · Apr 12, 2004

I feel that the instructor has put a student into a potentially culpable situation and put the entire case in even greater jepordy by having a student perform in a very questionable manner, for one thing the order did not even seem to bew clear from the way I read the OP something about "Here's what bothers me. .

I agree with u ccu nrs. The whole situation sounds fishy, but MY point is that as students, we should have the opportunity to be involved is cases such as the OP. Pallitive (sp?) care is something that isn't freely discussed and it should be! This is a perfect real life situation and the fact that some of the posters felt that a student should not have been assigned seems unfair to me. Yes, the orders were questionable and the instuctors actions were questionable but this makes for an interesting ethics debate and heightens awareness on this issue.

Love767 · Apr 13, 2004

I think my instructor was saying that it was euthanasia, and that it was common. I wonder if this really reflects reality or is just her impression of the way things are. The reason that I mentioned that the patient was an alleged child molester is because that is the reason the family gave for not being involved. Because the family wouldn't sign a DNR the ethics commitee had to be called upon to make the decision.

It seems as if most people do not believe that this was appropriate. To me there is a big difference between giving pain medications that may kill somone, but which are needed to control pain, and giving them in such a way as to hasten death. In any case our instructor ended up pushing the meds rather than the student, and the patient did pass away the next day on a different nurses watch.

Out of 100 terminal patients (or ones diagnosed to be so) how many do you think are "assisted"? Obviously, this will vary greatly by facility and location. It would be shocking to me if the number were greater than two or three, but I really don't know.

sbic56, BSN, RN · Apr 13, 2004

Love 767

Interesting question, but as you have learned, a hard one to be able to know the answer to because euthanasia is not only illegal, but a very political subject as well. My personal solution to the delemma would be to give the best care I know how and let my conscience be my guide. Don't do what you can't justify in court later or anything that will keep you awake at night.

KMSRN · Apr 13, 2004

It is euthanasia if the Pt dies one minute before they would have with out intervention and a Morphine drip of 2mg hr continuous will eventually build up to a dose that is not safe.

I agree with the first part about a patient dying ahead of the natural time. I disagree about the 2 mg/hr eventually building up. Many people have been on considerably higher continuous doses for extended periods of time.

CCU NRS · Apr 13, 2004

It is euthanasia if the Pt dies one minute before they would have with out intervention and a Morphine drip of 2mg hr continuous will eventually build up to a dose that is not safe.

I agree with the first part about a patient dying ahead of the natural time. I disagree about the 2 mg/hr eventually building up. Many people have been on considerably higher continuous doses for extended periods of time.

Yes but were they people that were conscious and having pain or people that were comatose with respiratory difficulty without mechanical ventilation? OP stated that the PT did die the next day.

KMSRN · Apr 13, 2004

Yes but were they people that were conscious and having pain or people that were comatose with respiratory difficulty without mechanical ventilation? OP stated that the PT did die the next day.

That doesn't mean it was the morphine that killed him. But it is hard to tell without individual assessment.