Syringe driver terror

Luckyyou, BSN, RN · Aug 18, 2017

People die because their disease processes are causing them to die. You have the opportunity to ease their passing with drugs. You are providing comfort when you cannot provide health. You are not causing these people to die.

If you can't or won't see the difference, you need to find a speciality where this will not be an issue. Dying patients deserve aggressive symptom management.

MunoRN, RN · Aug 18, 2017

I assume you're referring to the drug being administered by a syringe driver and not the syringe driver itself, are you referring to giving morphine or other pain medications at the end of life?

LovingLife123 · Aug 19, 2017

I assume you're referring to the drug being administered by a syringe driver and not the syringe driver itself, are you referring to giving morphine or other pain medications at the end of life?

Thanks. Wasn't sure what was meant here.

Here.I.Stand, BSN, RN · Aug 19, 2017

The ones I use usually contain Ativan (to keep them asleep and unaware while medically paralyzed) or Flolan (to help them oxygenate).

Anyone on end-of-life meds, I think not of the meds hastening death -- the meds make **the death that is already underway** more comfortable.

milly · Aug 19, 2017

I had hoped for some encouragement..

Iv hardly slept. Can hardly breathe and I just want to cry.. Hoping beyond all hope that I manage to survive today without a panic attack.

mrsboots87 · Aug 19, 2017

I don't understand what is so terrible. You're not murdering someone. You're keeping them as comfortable as you can during the time it takes them to inevitably die anyway.

mrsboots87 · Aug 19, 2017

Also, do you know how painful dying can be? And how much anxiety it can induce in the patient? Isn't it more caring to help ease those symptoms of dying so the patient can pass in comfort?

blondy2061h, MSN, RN · Aug 19, 2017

It's hard to be encouraging when you're being very unclear on what your concerns are.

macawake, MSN · Aug 19, 2017

Hello
I know that there will be allot of people disagree with me here

This is a really odd way to start a post. What are we expected to disagree with? You sound as if you realize that your opinion about something is quite controversial and perhaps inflammatory, and that it's probably one that many people will be opposed to. But you aren't being very clear. I suspect your fears have nothing at all to do with the syringe driver itself. Are you suggesting that we shouldn't treat a dying patient's pain? I hope that isn't what you're saying.

Am I only nurse that is quite simply terrified of syringe drivers?

I definitely am not terrified of them, I think they are a great. I use them every day in the OR and they are a valuable tool that helps me provide safe anesthesia.

What is it about syringe drivers that terrifies you (terrify is a very strong word)? You need to spell it out. Are you not properly trained in managing them and worry about not programming the infusion rate/dose correctly? Do you view them as some scary technical monster that can blow a fuse and run amok, suddenly delivering 50 ml in 0.1 seconds? (not that that could happen) What's so terrifying in your view? What are you so afraid of?

Are they really agents of death?

No, they are not.

How can you make peace with it all ?

I'm not sure what there is to make peace with, but I can guess.

Treating pain, nausea and anxiety when I have the means available to do that is the humane, professional and loving/caring thing to do. I know that it is the right thing to do, so I personally don't have to make peace with it. Not treating it is cruel. Knowing that I could ease a patient's suffering but choosing not to do so for egotistical reasons is simply not an option in my opinion.

Syringe drivers are great in that they permit good symptom control through steady levels of plasma drug concentrations. (You might still have to give a bolus or change the delivery rate as changes happens in the patient, but it's a good way to provide symptom control). Any type of infusion pump has this advantage as you avoid having to give multiple, repeated injections. It benefits your patient.

Please help me.. If got to get involved with it all tomorrow and I can't sleep..and I'm on the verge of a panic attack already..

What do you mean, get involved with? Are you starting a new job as a nurse? If you are, you do what you always do. Administer medications as they are prescribed by the patient's provider (as long as the prescription is correct and safe to give) and ALWAYS advocate for your patient. Make sure that your patient's symptoms are adequately treated. Your personal beliefs aren't the focus here, your patients' needs are.

You are not killing your patients when you provide good symptom control. Disease processes/ injury/old age is what's killing you patient. You have the power, and in my opinion the ethical obligation, to make the process less torturous.

I had hoped for some encouragement..
Iv hardly slept. Can hardly breathe and I just want to cry.. Hoping beyond all hope that I manage to survive today without a panic attack.

I'm not sure what we could say to encourage you. You seem to have a very strong reaction to this.

The only advice that I can offer is, treat your patients with nursing professionalism and kindness. Alleviate their pain and suffering using all the means at your disposal. Administer the medications that help them and offer a listening ear and a hand to hold.

Wuzzie · Aug 19, 2017

I had hoped for some encouragement..
Iv hardly slept. Can hardly breathe and I just want to cry.. Hoping beyond all hope that I manage to survive today without a panic attack.

I'd be happy to offer you some encouragement but I seriously have absolutely no idea what the heck you're talking about.

roser13, ASN, RN · Aug 19, 2017

OP, in looking at previous posts of yours, high drama and anxiety seem to be a theme. I hope that that last 14 years have not all been full of anxiety. If so, I hope that you've sought some help.

Please do explain what a syringe driver is and why it terrifies you. Some of us do not have a clue what you're asking.