Laurell28

I think it would helpful to request a meeting with the DON and hospice team members to air concerns on this man and his comfort (or lack thereof). This facility is in desparate need of education.

Sometimes you get a patient that becomes very special to you and when they die they take a little piece of your heart with them. I've had people say "you work for hospice what do you expect" but those I work with understand. I tell myself that its selfish of me to want them to stay when its time for them to move on. I keep their memories with me and think of the moments we spent together and I smile.

Please report what this lady is saying to the nurse and the social worker. What they can do is try to set up a meeting with the patient, the family and hopefully the MD/NP to voice the concerns and offer solutions. Hopices will give informational meetings if asked. Unfortunately you can't control what the family will do with the information. I'm glad that you're there for this lady. You sound very caring.

There is a perfect statement on the HPNA website regarding opioids at the end of life, particularly regarding respirations. It says no conclusive proof exists that opioids at the end of life will hasten death. I'll try copying the link, but honestly, I'm not exactly sure how to do it. http://www.hpna.org/pdf/Providing_Opioid_at_the_End_of_Life_Position_Statement_PDF.pdf

I get the same reactions about Hospice too and welcome the opportunity to educate people if they are really interested. It amazes me how much education and preparation go into a birth, but when it comes to death, little information is available and no one wants to talk about it. The ironic thing is that it is the one thing that we all have to face some day.

I would hold the Ativan but I would give the MS to maintain the comfort level that she had. If someone is premorbid or actively dying you would expect to see less responsiveness and lowered respirations. The attitude of the hospice nurse concerns me. She should have listened to your concerns and discussed them with you in a professional manner. Taking care of any person, espescially a dying person, is a team effort and all members and their input are valuable.

Congratulations!!! I got mine back today and passed too. WaHoo. That was one tough test.

20 yrs from now will you be saying to yourself "I wish I had spent more time with my children when they were young" or "I wish I had put more hours in working"? Your kids are only young for a short time. Enjoy them as much as you can.

GO FOR IT Once your wife sees that you are serious and working hard, she should come around and give you the support that you'll need. A person who is happy in their work has a happier home life.

I'm getting chills going up and down my spine reading these posts. I can't count how many times I've had pts report this to me and families find it comforting to know that there will be someone to help their loved one cross over. I'm a hospice nurse who is currently on leave to care for my dying father and for me the thought that my mother will come when its his time (she died 1 1/2 yrs ago) gives me some peace.

What a person does at the end of their life is their own choice but I am not comfortable with physician assisted suicide. I can see the right to die turn into an obligation to die (to save money or ease burden of family members) or an excuse to euthanize people whose quality of life doesn't meet others definitions.

Antibiotics do not always cure infection especially if someone has chronic infections and has been on them repeatedly. Also the side effects can be quite uncomfortable. So an infection can be a "terminal" condition. Allowing someone to die with dignity and comfort is not passive euthanasia.

Have you considered that the pt is doing so well because their pain is being successfully managed and without the pain meds they know they would be miserable?

I am a hospice nurse and I have been seriously asked this question many times. I tell them that I can't do that. I believe that these people are not afraid of death itself, but the dying process and loss of control. When assured that everything possible will be done to keep them comfortable and maintain their dignity, the fears are lessened.

I have a friend who is in the program at Metro State and she thinks its great. There always the U of M too. Welcome to Minnesota.