What would you do?

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If you had a terminally ill patient who was in agonizing pain whose son or daughter had power of attny for healthcare and wouldn't allow you to give narcotics because"I want mom aware so she can pray for healing". Seriously, would the hospital petition the court for guardianship? Would this be an ethics committee thing? All the while she is suffering and SHE(daughter) is the legal decision maker. Mom is coherent but refuses to go against kids wishes.

Thanks.

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Specializes in IMCU/Telemetry.
If you had a terminally ill patient who was in agonizing pain whose son or daughter had power of attny for healthcare and wouldn't allow you to give narcotics because"I want mom aware so she can pray for healing". Seriously, would the hospital petition the court for guardianship? Would this be an ethics committee thing? All the while she is suffering and SHE(daughter) is the legal decision maker. Mom is coherent but refuses to go against kids wishes.

Thanks.

Power of attny dosn't kick in until the pt is incompatent. While the daughter should have a say, I would have no problem disregarding her. I would fight her all the way.

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Specializes in Med/Surg, Ortho.

Mom is coherent, can make her own decisions. Daughter has POAHC for when mom cant make her own decisions. There is no legal right of anyone to step in if mom and kids are in agreement.

About all you can do is offer pain management, and ask the doctor to speak with them regarding comfort. It would actually be a violation if you even asked their pastor to speak with them regarding care issues.

I know its hard, but sometimes thats the situation you have to deal with. We arent there to impose our opinions on our patients.

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Specializes in IMCU/Telemetry.

:angryfire

Mom is coherent, can make her own decisions. Daughter has POAHC for when mom cant make her own decisions. There is no legal right of anyone to step in if mom and kids are in agreement.

About all you can do is offer pain management, and ask the doctor to speak with them regarding comfort. It would actually be a violation if you even asked their pastor to speak with them regarding care issues.

I know its hard, but sometimes thats the situation you have to deal with. We arent there to impose our opinions on our patients.

Agreed. I was very fast to reply as I hate to see my pts in pain. But if mom agreed to pain meds, I would give them to her, and to hell with her daughter.

If the pt was confused and asked for pain meds, I would think long and hard, but probably give them anyway. If she is alert enough to ask for them, she is alert enough to get them. JMHO

BTW My pet peave is family members who leave mom/dad in pain for their own reasons.As I said before, I HATE PEOPLE IN PAIN. :angryfire

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Specializes in Med-Surg.

Daughter doesn't have power of attoney yet, because mom is a&o. But if it's mom's wishes not to take pain medicine, then you really can't do anything.

However, I agree an ethics committee should be called. They should meet with the daughter to realistically speak to her and the patient, with chaplin services to explain while healing God doesn't want her in to suffer.(just my opinion). Sooner or later mom isn't going to be able to make her own decisions. Sad situation.

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Daughter doesn't have power of attoney yet, because mom is a&o. But if it's mom's wishes not to take pain medicine, then you really can't do anything.

However, I agree an ethics committee should be called. They should meet with the daughter to realistically speak to her and the patient, with chaplin services to explain while healing God doesn't want her in to suffer.(just my opinion). Sooner or later mom isn't going to be able to make her own decisions. Sad situation.

Suffering has its beneficial aspects. One Saint said something to the effect that you can't avoid suffering in this lifetime, and if you do, you will suffer in the next.

Just room for your diversity thinking...

NurseFirst

Uh-oh. I think I may be doomed. :o

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I was in a situation very similar to that and we had an ethics committee. I wish I could say something positive came of it, but nothing really did. The patient expired.

Its very difficult. You should at least share the burden of this patient with your coworkers, and discuss the issue with your NM. You guys probably need some support... situations like this are traumatic for everyone, especially nurses.

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Specializes in Med-Surg.
Suffering has its beneficial aspects. One Saint said something to the effect that you can't avoid suffering in this lifetime, and if you do, you will suffer in the next.

Just room for your diversity thinking...

NurseFirst

Uh-oh. I think I may be doomed. :o

Buddha said it too "life is suffering". The Road Less Traveled begins with the sentence "Life is tough" or something like that.

But also Jesus came to relieve suffering, heal the sick and the pain. Whose to say the nurse or the doctor or the pain medicine isn't Jesus talking.

I'm very diverse in my thinking, which is why you have to walk a fine line with respect of the persons beliefs and you're own.

Uh-oh. I think I may be doomed right along with you. :)

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Pain is the fifth vital sign, right? OK, there is no excuse for disregarding the patients pain. I think I better tattoo it on my forehead... DNR and MDP (morphine drip please!) muah.. love yas

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Suffering has its beneficial aspects. One Saint said something to the effect that you can't avoid suffering in this lifetime, and if you do, you will suffer in the next.

Just room for your diversity thinking...

NurseFirst

Uh-oh. I think I may be doomed. :o

I respect you for being a healthcare professional, but please do not make decisions based on your religon..for my own sake if I were a patient... I have different views.... and I AM the one suffering...

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Specializes in Geriatrics.
Originally posted by NurseFirst

Suffering has its beneficial aspects. One Saint said something to the effect that you can't avoid suffering in this lifetime, and if you do, you will suffer in the next.

Um, yeah, I agree to that (I'm Catholic), and that's great for those of us who choose to use their suffering as a way to salvation. But the patient involved may not make that choice, and if they don't intend to use their suffering in such a manner, it doesn't do them much good, and we as their caregivers are failing our job for letting them be in pain without any relief. Of course, if they (or their loved ones if they aren't able to decide for themselves) don't want painkillers, you can't do much about it.

Sorry if this doesn't make much sense, but I'm in a hurry b/c I need to flee the computer to go somewhere.

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Specializes in Med-Surg.
Pain is the fifth vital sign, right? OK, there is no excuse for disregarding the patients pain. I think I better tattoo it on my forehead... DNR and MDP (morphine drip please!) muah.. love yas

Excellent idea!

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