oxygen in dying hospice patients

Nurses General Nursing

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hey everyone, new here to the forum! and i just have a question that i can't seem to wrap my head around. When patients are on their last days, the doctor removes the meds, and nurses are providing morphine, why are some patients also applied o2? I know commonly they receive 2l, so is that keeping the patient alive? if they were to remove it would they die shortly after? just curious because it was something a couple of my nursing friends were discussing. what are the real benefits of the o2?

Specializes in Hospice.

I agree that the comfort of nurses is irrelevant, but the comfort of the family is not. Care of the family is just as much a part of hospice nursing as the care of dying person. Sometimes there is conflict between what the family wants and what the dying person needs for comfort. Then the choice is clear. But I don't think we should be assuming that that's always the case.

In caring for a dying person, in the hospice paradigm, it's totally inappropriate to dismiss the needs of the family. That's why hospice companies must provide social, spiritual and especially bereavement counseling.

Addressing the needs of both the family and the patient is just about the hardest part of end-of-life nursing.

For anyone who hates the feel of nasal prongs, it might be an idea to memorialize that in your advance directives and conversations with your respective POAs. For the rest of us, all we have to go on is observation of the patient and information from the family. For anyone who was chronically oxygen-dependent in life, I assume that room air >> air hunger and/or anxiety even if unresponsive unless I see restlessness relieved by removing it.

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Specializes in Hospice.

I do it on a case by case basis, and always tell families and staff that it's ok to take it off if the patient seems to be irritated by it. It's also easier when it's ordered PRN rather than continuous, especially in facilities that are afraid of getting dinged.

When you explain that 2L is only a slightly higher concentration than room air, families are generally able to let it go if necessary.

Back in the day, everyone got O2 when they were transitioning or imminent. Now, not so much. Roxanol, Ativan and Atropine drops are wonderful for alleviating oxygen hunger.

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Specializes in Pediatrics.
Don't beat yourself up too bad it's a common mistake on TV. Look at the Medical Mistakes on TV thread.

https://allnurses.com/nursing-humor-share/ridiculous-medical-mistakes-997478.html

*whisper*

your username violates the TOS

ETA:

Nevermind.

Thank you *so* much for linking the medical mistakes thread. I have been solid laughing for 15 minutes now. I had no idea so many miracles happen around us, every day! :p
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Lay flat remove the 02 and many will die much quicker.....

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Specializes in 15 years in ICU, 22 years in PACU.
Mavrick, when you're actively dying, CO2 buildup will probably be the least thing you'll worry about.

Comfort is as comfort does. Whether it makes sense to us or not. End of life care doesn't think along the same lines as acute or critical care.

Sorry, my sarcasm font is on the blink again. I was implying that CO2 narcosis is something I would welcome to ease my transition as it could be called dying of natural causes.

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Specializes in NICU, PICU, Transport, L&D, Hospice.
Lay flat remove the 02 and many will die much quicker.....

So, in your view, the goal of a hospice patient is for a quick death rather than a comfortable death?

There is no right or wrong relative to O2 delivery in a hospice patient, especially one who is near death. It really is all about the goals of care that were identified and planned for at the beginning of the EOC/EOB.

If the goal is for comfort and peace at end of life and the O2 seems to provide some of that then it would be inappropriate to DC based upon the belief system or thoughts of the hospice RN.

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Specializes in Hospice.
Sorry, my sarcasm font is on the blink again. I was implying that CO2 narcosis is something I would welcome to ease my transition as it could be called dying of natural causes.

Well, since the legal definition of Hospice states "If a disease or condition is allowed to go to its natural conclusion, which is death...", dying from whatever your terminal diagnosis is WOULD be a "natural death". 😘

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Lay flat remove the 02 and many will die much quicker.....

how true is this? can laying a resident flat really be that dramatic of an effect? most of them are laying on their pillow they are sort of elevated.

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Specializes in Complex pedi to LTC/SA & now a manager.
how true is this? can laying a resident flat really be that dramatic of an effect? most of them are laying on their pillow they are sort of elevated.

If suffering from pulmonary edema or congestive heart failure flat = death by pulmonary congestion.

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If suffering from pulmonary edema or congestive heart failure flat = death by pulmonary congestion.
how about as far as just natural death? if that is what you would call it
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also, everyone that is going to die gets fluid in the lungs correct? it's the natural process of death. is that considered pulmonary edema? or am I thinking death rattle

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Specializes in Complex pedi to LTC/SA & now a manager.
how about as far as just natural death? if that is what you would call it

Natural death is death from a human physiological process. Unnatural death is overdose, hominids, suicide, murder..,

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