Syringe driver terror

[milly]

Hello

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

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

I just feel like I'm helping someone die. I didn't want to be a nurse to help someone die.. I wanted to be able to provide comfort and health..

Are they really agents of death?

How can you make peace with it all ?

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..

Milly

[brownbook]

Is this post for real? I'm beginning to wonder about some of the posts lately.."can I stay home and take care of my BF who has a patch on the back of his head" now this one..more and more this site seems to be drawing in either fakes/drama driven or really immature nurses..or so it seems.

I've thought this for several days, the one about pay expectations is good also. I hope they are trolls, but they are kind of fun to read.

[Here.I.Stand, BSN, RN]

Milly, you should check this out --

National Hospice and Palliative Care Organization -- the site of the Nat'l Hospice & Palliative Care organization. They have a wealth of information about the goals of palliative care. Actually I directed my mom to that site a few months ago; she made the decision to bring my grandma home from the hospital for home hospice care. My guano-crazy aunt had shellacked my mom for "giving up on" their mother.

As I explained it, it is NOT about giving up on her at all -- it's recognizing that she was 94 yrs old, frail, and that medical treatment wouldn't reverse her CHF, COPD, multiple bouts of pneumonia, and multiple bouts with DVT/PEs. It was recognizing that she should be in the home she shared with her husband of 67 years -- not in the hospital. That she could have her children cooking that good farm food that she loved, rather than hospital food. And yes, that relief of pain/anxiety/air hunger was an important goal.

I would strongly encourage you to seek out some CEUs on palliative care. You seem to be hanging onto some misconceptions about it, despite all of our education. I'm concerned that you will allow your misguided concerns to influence pt care -- BUT I do sense that you are a caring nurse and want to provide good care. Perhaps some dedicated palliative care ed will help mold that compassion into an excellent, informed end-of-life clinician.

[ReClarked]

Milly, I read your posts and just have a couple of things to add.

First, I hope you never take care of me or any of my family if we need palliative care. And before you get offended, let me give you some constructive criticism as to why.

You do not seem to understand the difference between goals of care. With most patients, your goal is to restore health. When that is not possible and patients are actively dying, the goal is to restore comfort and dignity.

No dying patient should EVER have to suffer, especially when they have a highly trained medical professional (you) with them, overseeing their comfort needs. To withold comfort measures, whther it is dilaudid or a warm blanket, is just out and out cruel. Your function is to alleviate that suffering and, apparently, having mercy on the dying causes you way too much personal conflict. You have no business providing palliative care if you can't wrap your brain around allowing nature to take it's course.

If you sincerely believe you are killing people, quit your job and find a school nurse position. If you sincerely believe you are killing people, turn yourself in to the state BON and your local police department because, after all, that would be the ethical thing to do and you appear to be struggling with ethics.

I use this as an extreme example, but your post is extreme. Milly, the palliative care nurse is a superhero. They take away the agony of death, the anxiety, the stuggle to breathe. If you think it is right to allow those things to happen to your patients, you are in the absolute wrong line of work.

People euthanize dogs so animals dont have to suffer the fate you would have your patients suffer. The reason dogs are eithanized is because there is no canine palliative care to provide HUMANE end of life cares. Your patients DO have humane end of life options and you are too conflicted about letting them have them. You're going to burn out. Worse, you're risking your patients' right to comfort by potentially denying them the medications and treatments they deserve.

My advice to you is to make anappointment with a palliative care MD to discuss what palliative care and comfort cares are about, goals of treatment, expectations and ethics. Voice your fears with someone who can intelligently speak on the subject. Get super-educated, then make a decision you can live with. Your patients depend on it.

Whatever you do, I pray that you find a solution that brings you peace because, rather than morphine or dilaudid, that is really what you're goving your patients and you deserve to have some too. :) Best of luck!

[JKL33]

Voice your fears with someone who can intelligently speak on the subject. Get super-educated, then make a decision you can live with. Your patients depend on it.

It strikes me as a bit unfortunate that a number of posters seem not to have seen this original post here on AN as exactly that sort of attempt of which you speak. And then there have been a number of replies that do, in fact, include very relevant information.

I know it makes folks feel really super great and superior to respond with disdain to these kinds of posts, but the anxiety expressed in the OP and subsequent posts, to me at least, seem to represent an ethical crisis based on lack of information, and I choose to believe that's why the OP posted here.

[traumaRUs, MSN, APRN]

Okay everyone - please post within the terms of service to which everyone agrees when they join.

Posts have been edited/deleleted to conform to TOS

[Apple-Core, ASN, BSN, RN]

OP - I have experienced life at both ends, as a doula (birth) and as a volunteer in hospice (death). What I can tell you is this, (and of course this is my own personal take on it so make of it what you will)...death, if handled with dignity and reverence (which it sounds like you do) can be as profoundly moving and positive as the birth. Yes, there is grief, and yes there is loss, but somehow in the midst of all that there is also the incredible experience of life's end, and it would be (again, IMHO) a terrible injustice to bring fear and anxiety to what could be a profound experience.

There are some - many - moments when that experience is taken from us/the family/the patient because of injury or sudden illness, for example. But in palliative care environments, we have the opportunity - indeed, the responsibility - to embrace the inevitable and make it as pain-free and respectful as possible which encourages moments of true and lasting human connection for families and loved ones.

[ComeTogether, LPN]

Palliative care (and then hospice care) was a godsend to me. My beautiful 3 year old son died next to me in bed at home. And everything was peaceful. I had watched him have a horrific code (30 minutes long and then ECMO) 16 months prior, so I decided I was going to choose a peaceful (and inevitable) death for him. The last part of his life, I didn't want him to struggle or feel pain! And thanks to palliative care (and hospice) it was very minimized. I wasn't stupid, I knew he was going to die. I'm thankful palliative care guided me through that process.

Without those pain meds, my very young heart would have been ripped out even more watching him struggle.

You are not killing anyone! When I started my son in palliative care, I already knew, their was no 'curing' or fixing what he was going to die from. It was about quality of life. And that is way more important than quantity. I was not in control, my son't doctors were not in control, and his nurses were certainly not in control.

I wish I could wrap you up in a great big hug.

Thank you for being brave enough to share your story so others can learn. I know it's got to be painful.

[ComeTogether, LPN]

You realize and understand you are giving them opioid or other medications to relieve their suffering and that you and the patient understand the adverse effect of the medication can be severe respiratory depression. But you are not giving it to depress respiration, you are giving it to relieve pain and suffering. If you believe or state that you are giving it for it's respiratory effects, then your are engaging in assisted suicide etc. That's how it as explained to me from a legal perspective.

If you have it in a non-palliative/hospice patient and did not address respiration less than 12 or 10 or whatever with appropriate nursing interventions, then that would be a whole different topic.

BEING MORTAL is a good read that I think will benefit you. The.video is quite different but you get the idea. The author is a physician. Being Mortal |

FRONTLINE |

PBS

Morphine actually is a great respiratory drug. I just used it last night for a COPD pt with respirations in the 40's and SAT ing in the 80's.

[kdkout, BSN, RN]

I am not convinced this post is real. For one, too many spelling errors and odd word choices. Two, I hate to think of you actually working in palliative care with so little understanding of....everything.