Ok, the problem that I have is with Hospice and the rules. I am a LVN at a hospital and I had a pt last night that is on hospice. The Dr. and the family is waiting for the guy to die, so at the start of my shift the Dr. had ordered for the pt to receive Dilaudid 1mg EVERY hr PRN. However I did not feel comfortable giving that much and I told the family that it is PRN and the pt was sleeping and VS were all normal. So I gave 4 doses thru out the 12hrs, so he did not die thru the night. The Dr. got there at 5am and noticed the pt had not died yet, he took the charge nurse aside and told him to have the family step out and smother him with a pillow! He in turn told me what the Dr. said and I about freaked at how he could even say such a thing. Anyway, the Dr. came back at 0700 and ordered Dilaudid 1mg every hr (not prn) and adivan every half an hr until death. Of course the Pharmacy called up to clarify the order and told the on coming nurse that she did not have to give that much and to use her judgement with it. She had the same feeling as I did. This is not right and she also said there was no way she would give that much just to speed up his death, and with 5 other pts there was no way to even keep up with it.
So, what can I do or because he is on hospice it is ok to give him lethal doses to speed up his death.
P.S I just called to check to see if he had died yet and he is still alive, with good vital signs.
