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Has anyone every come across any information on what the role of a nurse is in Washington or Oregon when it comes to physician-assisted suicide? I'm under the impression there isn't much for a nurse to do, since the patient has to be able to self-administer the overdose of medication. But any info would be of great help. Thanks

Well, since I was last in here I have had an in-depth discussion with this nurse, and she sent me some information. It is the note she wrote in the patients progress notes, and this note is what the MD referred to as having read. Without any names there isn't any identifying information, so I will go ahead and post it in here. When I read it, I thought it was basic education, but she says she was fired without any warning after the MD read it (and then said he wouldn't admit any patients if this nurse was still working there): 30 Apr 09 1800: Pt on vent + sedation gtts are on but pt is struggling against restraints. Daughter @ BS and I disucssed c her that we are unable to sedate him appropriately becasue his blood pressure drops too far and @ this time the MD does not want him on vasopressors. We discussed end-of-life options and DNR/DNI. I expressed to her that the pt appears to me to have gotten worse over the last seven days rather than better (edema, decreased BP, cardiac issues, increased FiO2 to maintain sats, lung sounds, etc). Pt. family in tears thanked me for discussing EOL, DNR/DNI, "because" she said, "No one is telling us anything." She stated: "I needed to hear this." I said to her that Dr --- may have a different opinion and that she is he MD, but that in my experience a pt in this condition @ his age often does not improve and they may want to begin to thin about the possibility of LTC c tracheostomy, PEG tub, and longterm vent support vs. comfort measures only. According to this nurse, she had this discussion because the patient had been left badly gagging and struggling on the vent for three days, was getting worse every day, and the wife (who was somewhat "simple" according to the daughter) beleived he was getting better because the MD would come in the room take a quick look and walk out saying "Looks good!" She said they wouldn't sedate him enough because they would have to start vasopressors and the talk among the residents was that if they started vasopressors they would never get the patient transferred out of their ICU. She said the patient actually died on May 5th, six says after she had this talk with the family.

Thank you very much, it sounds like this isn't something that is specifically a nursing function. Well, actually with both responses it sounds like it may be or may not be. But I thought we were supposed to educate our patients. It's all very confusing.

On another forum a nurse posted that they were fired for having an end-of-life discussion with a dying patient's family. Supposedly, the family thank them and cried because they needed to know what options were available and none of the MDs were talking with them. I guess this nurse told them they could elect comfort measures only, and when the MD found out about it, the nurse was fired without warning because the MD insisted on it. Do you think, we as nurses, are allowed to have such discussions with patients? In school it seems they teach we are to advocate for our patients and tell them about their healthcare rights, but if one can be fired for it, I'd rather know before making the mistake.

I intend to work until I am 70, but I'm not sure in what capacity.

How long is this going to continue? How long are we going to have such horrible patient-to-staff ratios? I suppose as long as we're willing to do it, the people with the money will keep putting it on us. If we don't unionize at some point, nursing will become a revolving-door profession. That is, new nurses are churned out to replace the nurses who have been overworked and/or have lost their licenses due to poor patient care--poor patient care resulting from inhuman expectations. But, so long as we need the paycheck, we will keep doing whatever they say. But it sure seems like something has to break. Maybe we should all quit, and then advertise ourselves as private contracted nurses. I'm just so POd at what is expected of nurses for less than half the pay of an MD--OR A PLUMBER!