Oregon doctor will be disciplined AGAIN for pain treatment

  1. The Oregonian, Aug. 13, 2002

    For the second time, the Oregon Board of Medical Examiners plans to discipline a Roseburg doctor for failing to give sick or dying patients enough pain medication.

    Last edit by NRSKarenRN on Aug 15, '02
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    About NRSKarenRN, BSN, RN Moderator

    Joined: Oct '00; Posts: 27,549; Likes: 13,755
    Utilization Review, prior Intake Mgr Home Care; from PA , US
    Specialty: 40 year(s) of experience in Home Care, Vents, Telemetry, Home infusion


  3. by   fedupnurse
    Scary thing is I have worked with nurses like this. Terminal patients on vents and she had the Diprivan going at 5 mcg's and couldn't understand why they were bucking the vent. She went to lunch one day I went in and titrated up the sedation on both of them and told her when she got back from lunch that they were now comfortably sedated and if she touched the rate on either one it better be only in the up direction. She left the rates alone and we didn't hear those vents the rest of the day. This was a usual occurance with this nurse and we were all happy to ehar that she resigned, shortage or not!
    There are a few others who act like morphine costs a million bucks and is coming out of their pockets. Just don't get that! Why suffer if you don't have to!
  4. by   SmilingBluEyes
    Let people like THIS be in horrendous or intractable pain and see how quickly their attitudes might change. Too bad every dr and caregiver cannot be subjected to EXACTLY the kind of care he/she delivers...they would be either rewarded or suitably punished, giving them tremendous insight to what our patients go through. Oh but for karma.....
  5. by   Dr. Kate
    Glad to hear of official sanctions of anyone who undermedicates a patient. It's about time.
  6. by   Jamesdotter
    The first time I ever "overmedicated" a pt was a man with bone mets whose Dr. had ordered MS 15 mg (or maybe it was 20 mg--it was more than 30 yrs ago) q 2 hrs with scop. It was what the man and his family wanted--no pain and little awareness. It seemed to work for him. I was appalled at the dosage at the time, being new in the profession. Fortunately there was a wise older nurse who assured me that it was the right thing to do, so I gave it on schedule.
  7. by   formernurse
    I was able to give my sister 20 mg. of Morphine plus a scop patch q2h for the last 12 hours that she lived. It was reassuring to know that her last hours were comfortable.
  8. by   emily_mom
    Sick, sick, sick. I'd like to see this doc be in this pt's shoes and maybe be wouldn't be such a cruel heartless jerk. My mother died of pancreatic cancer, and I would have killed the doc who didn't properly sedate her. Morphine rocks.

  9. by   deespoohbear
    My favorite line about pain meds and terminal pts is "What if they get addicted?" At this point I just say "give them what they want, for pete's sake. I am very pro pain meds. I get really aggravated when other nurses don't adequately medicate, or doctors who fail to order adequate pain relief. I have a reputation for calling the docs until I get what it takes to get pain relief for the patient. If I am terminally ill and in pain, someone better make damn sure I have what it takes to get me relief. Same goes for my family. No one should have to suffer. Period. (Unless it is those scum child abductors. They can be thrown into the pits of hell).
  10. by   cargal
    Any suggestion for abdonminal pain suffered by patient with megacolon? Md doesn't want to prescribe narcotics to slow down peristalsis. Resident is tube feed and hurts all over, too, just to touch her. Ultracet one q shift is ordered now. How about elavil?
    Thanks colleagues.
  11. by   psychonurse
    I think that all male doctors should go through a vasectomy without pain medication and see what happens. I have seen too many patients suffer. My father was one of those, a nurse stopped his morphine drip cause his respirations were 10..Had to fight him for three days and when he got tired then we got the iv restarted and got the drip going again......never again and I will never let anyone suffer ever again......some doctors afraid of people getting hooked.....glad I don't go to any of those doctors I would have a fit......
  12. by   sjoe
    Cargal: My Rx--for the patient to get a new doctor!
  13. by   Jay-Jay
    Thank god, a lot of the docs in home care know what they're doing when it comes to pain meds for terminal patients. Had a 92 yr. old with gangrene in both legs, plus multiple health problems, and the family had decided that at her age, amputation was not an option. She was not eating or drinking, and on my morning visit was only semi-conscious. She was getting morphine sub-q by butterfly needle, with boluses q 15 minutes if needed (don't really remember the rate).

    I came in again that evening, at the end of a VERY long day, and she was awake, alert, and obviously suffering. Her lungs were filling up due to her heart beginning to fail, and she was fighting for breath. I called the doctor on call, and when he FINALLY got back to me, he said: "I know nothing at all about morphine pumps. Her primary doctor said I would have to come and sign the death certificate, and that was it. Sorry!"

    Well her doctor had been smart enough to leave a titration order for the morphine, so I bumped it up and kept bolusing her until she was comfortable and somewhat drowsy. (Do you think I even bothered counting respirations??? Are you kidding??) I told the doc. that usually end-stage patients were given Ativan or Valium to calm them down if they were in respiratory distress. He agreed to the Ativan, but only ONE milligram!! We got a scopolamine patch for her, too, and I told her daughter to not be afraid to give 2 Ativan.

    She died peacefully several hours later. The last thing I did before leaving her was pray for her. The daughter was so touched by everything I'd done that she called both my boss and the CCAC office to make sure they knew what terrific nursing care her mom had had.