Suicide

Wow------Bless you! Without violating Hippa, what happened and how did you find out that if a client attempts suicide, their DNR is null and void.....

I've never run into this, but it doesn't mean i won't......

I don't agree with this. Not one bit. I can however see the hospice not wanting to appear connected at all. But that poor soul.

I am not certain it is legal to nullify the DNR against the consent of a mentally competent patient.

Having said that, I don't agree with it philosophically either. The patient has a terminal diagnosis. They are likely experiencing some pain (emotional, spiritual, physical) which contributed to their decision to attempt suicide. Removing the DNR punishes them for making a bad choice but resolves nothing.

I took care of a pt who attempted suicide, and then decided she wanted to stop tube feedings and be on hospice. An ethics panel decided this was okay, as she was competent, and 3 months later she is still alive.

Had a patient years ago that committed suicide via shotgun in the mouth. The DNR wasn't even mentioned. Our whole team was traumatized, but the director of the hospice was super supportive, and arranged group and private counselling with a psychologist when/if we needed it. It was very difficult for the family, but they weren't terribly surprised, just shocked. The poor patient couldn't tolerate the anxiety, even though we had done everything we could think of. It really felt like a failure.

Although I am not a hospice nurse, I believe that suicide in the face of an unbearable terminal illness is acceptable. It is a choice, and maybe more than that, a need. Years ago my oldest sister was terminally ill with ovarian cancer that spread throughout her body, she was always in severe pain and had liquid morphine. The family kept the morphine out of her room, and she was not able to get to it on her own. She lived in another state, and when I visited, my mom told me that the morphine had to stay out of my sister's reach, and gave me that look as to say, you know why. I went ballistic and told my mom that pain medication should be in her room where she could access it, as she may need the med when alone or when everyone else is asleep. I also told my mom that if it was my sister's decision to take her own life by overdosing, that was her right. My sister never did that, she passed away about 2 months later.

Dr. Kevorkian had a plan. It may not have been perfect, but could have been. Animals receive more compassionate care than humans when terminal. Why is this the case?

Thanks for letting me rant.