nurse says, do you want her to be in pain

[time4meRN]

Worked with a nurse that was admitting a pt. She was obviously burnt out. She took the pt off all of her meds, parkinson, clonidine and tylenol. The family was concerned that the women was having nerve pain and taking her off these meds may increase her pain and they also said the pt takes tylenol for pain and anything else may sedate her. The pt was complaining of leg pain at night. The family suggested kindly to her that she has had leg pain before and it is due to " charlie horses" and they give her another med for that ( gosh darn , can't think or the name". but the family said it worked wonders for her.) Any way, the admit rn insisted that the family was intent of their loved one being in pain and became very inpatient with them. She started the pt on morphine , po and valium at night.. atropine prn. They argued why they couldn't start her on vicodin first and then increase if needed from there. The rn lookied at the poor 86 year old man and said , " do you want your wife to be in pain or what". I was really taken back. The pt simply had leg pain at night. ( from neuropathy ). The pt was smiling and eating and drinking prior to the visit. To make a long story short, the pt passed, 2 days later, in worse pain. I don't get it. :redbeathe

[ErinS, BSN, RN]

I think in a lot of ways this is the way some hospices operate- take the person off everything and let them die. In my hospice we have tried to find a place that allows good symptom management, but also good quality of life. Many patients need to stay (or should stay) on their medications unless they are imminently dying. I have also found that tylenol and lortab really work quite well most of the time, although it seems to be rare that patient's do not eventually need a stronger opiate, like morphine. It is too bad you witnessed this. It really gives hospice a bad reputation.

[tewdles, RN]

Yup, you witnessed a not very good example of hospice nursing practice.

[time4meRN]

I still have complete faith in hospice, It's a job that is good for the soul if it is kept in prespective. I was just really taken back by this nurse. I've been a nurse for 30 years, ed , icu etc. and I pray I have never made a family member feel guilty in any way for their decisions about their loved one. I always try to keep in mind people are doing the best they can at any given time. family members will make decisions based on stress levels and many other factors. If I meet her again I will act as a pt advocate, and speak up in an appropriate setting. She needs to get a grip. But thanks for listening.