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ordered to give roxanol with resp. of 5

Nurses   (13,718 Views 55 Comments)
by wantsthebest wantsthebest (New Member) New Member

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Go back and read the original post again.

I don't understand why they would. The person is dying. rr 5/ min? no response to stimuli? What difference is it going to make? In these situations you have to remember that your treating the family also. This is how this person will remember the death of their loved one forever. It sounds like the family member doesn't want to see the patient suffer. The fact that based on our viewpoint the patient looks sedated and in no pain means nothing. Perhaps based on the belief of the family member the patient will suffer until they make it to their final destination. When it comes to death you have to consider these things. You are not preserving the life or quality of life, you are assisting in the quality of their death, and the family's remembrance of a loved one in their fiinal moments here on Earth.

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I am a firm believer in active euthanasia.

HOWEVER.

The meds being administered had nothing to do with the patient's pain and everything to do with ending his life. I even more firmly believe in the right of a health care provider to opt out of giving that unnecessary- for- pain- and- solely- because- it- is- lethal dose.

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The meds being administered had nothing to do with the patient's pain and everything to do with ending his life. I even more firmly believe in the right of a health care provider to opt out of giving that unnecessary- for- pain- and- solely- because- it- is- lethal dose.

thank you.

leslie

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205 Posts; 3,442 Profile Views

Usually, when it comes to this kind of touchy subject, not all nurses in a facility feel the same way. This, I think, is a wonderful thing because if one nurse - like the original poster - is uncomfortable with giving a dose of pain medicine per the family's request, despite an okay from the doctor - there is usually another nurse at the same facility who *would* be comfortable giving that dose of pain medicine.

I agree that the original poster did the right thing for her in that situation, as she was not comfortable giving that dose of pain medicine. However, I think that someone should have ensured that the right thing was done for that family, and that could have been accomplished by either the doctor giving the med himself or finding another nurse who was willing to do so.

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icuwant2rn has 1 years experience and specializes in Med/Surg.

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Usually, when it comes to this kind of touchy subject, not all nurses in a facility feel the same way. This, I think, is a wonderful thing because if one nurse - like the original poster - is uncomfortable with giving a dose of pain medicine per the family's request, despite an okay from the doctor - there is usually another nurse at the same facility who *would* be comfortable giving that dose of pain medicine.

I agree that the original poster did the right thing for her in that situation, as she was not comfortable giving that dose of pain medicine. However, I think that someone should have ensured that the right thing was done for that family, and that could have been accomplished by either the doctor giving the med himself or finding another nurse who was willing to do so.

I agree. When someone at our hospital is uncomfortable with giving (an unreponsive DNR patient in the hospital for comfort measures) pain meds there is usually someone else willing to give it.

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Sunflowerinsc has 46 years experience as a ADN, RN and specializes in Med/Surg.

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Each time you have to think about what the pt wanted and now how the family is assuring their wishes are being carried out for them. And think, the point of a pain or sedation medication for a terminal is NOt to hold it if there are no signs of pain,ect. It problably took 3-5 days to get to the effective dose so if it is held ,maybe a couple hours later the pt will show active signs of pain, and that is not the point of comfort care., NO pain is the goal and holding scheduled dose causes the cycle to start over again.

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11,191 Posts; 53,722 Profile Views

i totally agree w/staying ahead of the pain, but the goal would be to maintain resps at 8-12.

even changing the order to q3h would probably be more appropriate.

leslie

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2 Posts; 693 Profile Views

of course this is only my opinion but after working w/pts @ end stage life,who are we to determine whether they are suffering or not just because they may not exhibit the text book s/s if i were this pts nurse he would have been given the roxanol in fact i have worked w/hospice nurses who also feel this way to me it is not only dying w/dignity but a way to let this person go without laying in a bed wasting away every hour that goes by. i do empathize with your situation as it seems you may feel some conflict ie this,but do not feel alone there are many of us who have been thru this before and though it is not easy to accept these issues, i would ask myself if it was me what would i want hospice or the md to do for me,i can say i certainly would not want to be laying there in that state. sincerely coop62

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6 Posts; 1,437 Profile Views

My question here is... was he able to eat, and she didnt want him fed? I would have a serious problem with someone who ate with assist, and his wife getting orders to make him NPO. Is she trying to starve this poor man to speed up the dying process?

Stacy

he was eating, we were taking him to the dining room and assisting him. she stopped us taking him there, insisted we bring a tray to his room, then, took over the feeding herself. he lost weight, we got orders to feed him after she left, he stabalized, she got the order for NPO.

I feel like I am living a nightmare........it is now 15 days, and no changes. It is not God's will for him to be gone yet. No one I work with will give the drug unless he fits the parameters that our medical director has set. She has been told that if she wants him to have it, she can get the order for the family to administer, she has chosen not to. Seems that she wants us to be the ones to off him, not her or her son. Starvation and dehydration are horrible ways to die, but so is assisted murder. I have to believe that somewhere out there there is plan........I just dont know what

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11,191 Posts; 53,722 Profile Views

why did the wife obtain an npo status, esp where he was gaining wt again?

did he get a swallowing eval?

did he lose his ability to swallow?

i've seen many premature npo statuses.

when giving po care, it bothers me immensely to see pt sucking away on the toothettes.

a swallowing eval would be most helpful.

if he's truly dysphagic, then comfort measures are indeed indicated.

but if he's not...

leslie

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Jo Dirt has 9 years experience.

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Thanks for the extra info. With all the backup of supervisors, etc. it sounds like you were technically ok to withhold the drug. But I still agree with the doctor.

Personally, if I were that man, I would want the morphine given to me, in fact, in situations like this I fail to see why euthanasia would be inappropriate. I know it is technically illegal and some are morally opposed, but when you say "do no harm," do you think allowing a man to slowly die over many weeks is less harmful than giving him a pain medicine that may speed his death as a side effect, when death is inevitable with either option? I think it is fairly obvious that not feeding/hydrating him is itself euthanasia, the only difference is it is passive. I would rather be active and be SURE that he was painfree rather than hoping that inside there somewhere he wasn't aware of his situation.

I have to agree with this. I believe to give this medication might have mercifully put and end to not necessarily the patient's suffering (who likely didn't know he was in the world at this point anyway) but the family who had to watch him die this way.

I also, believe, though, I might have a hard time with this, knowing I was the one who ultimately pushed him to eternity. I also know we have had it so pounded into our heads that our mission is to save lives it just goes against everything we have been taught to give "that last dose" even when the patient would be much better off. I hope I'm not put in a situation where I would essentially be ordered to euthanize a patient. It has to be an eerie feeling.

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