So I am not a nurse yet, but I would like to enroll in a community college to become one. My concern is that when a doctor orders me to draw blood 2-3 times a day to an elderly patient, this will hasten their death. Or if he orders me to give them morphine or something which also accelerates a patients death. I am not being cynical or anything. I know doctors are out there to help people. But I just remember a time, where a nurse would draw blood from my grandma three times a day, and the head nurse shouting "this is BS, THE LABS DONT NEED THIS MUCH" And the doctor refused to listen to the head nurse and said the blood is a must for lab work.
I really want to become a nurse, but this has put fear inside of me. As a nurse if I feel it's too much blood to draw from a patient- do i have the right to tell the lab and doctor, "sorry, if we take anymore, the patient's death will be hastened."
Thank you NightNerd, I really liked your details and I will shadow a nurse. As I stated I have grown up with superstitious family members who lack medical experience. And my cousin nurse is always grumpy and I believe to be bipolar. I dont know how she is still working as a nurse. She once told me that doctors order lots of blood from anemic patients so they can give another patient the room. But then again I dont know why I listened to her, when she takes l ike 20 different vitamin pills on an empty stomach each morning and tries to encourage me to do the same. I believe I will find much relief when I begin my nursing education. I am done with these stupid horror stories ppl tell me. I cant wait to become educated.
The usual amount of blood taken for a CBC is max 7mL, a BMP is 4mL according to our vacu-tubes. This is just shy of one teaspoon of blood. ONE TEASPOON. That will not hasten death. The average woman loses twice that each period.
MORPHINE DOES NOT HASTEN DEATH. get that out of your mind right now.
You only saw a snapshot of an interaction. You have no clue why the nurse was 'screaming' (sounds like there may have been other issues in play I'd she was screaming in front of family). Or why the doctor ordered those tests.
You might want to actually observe a nurse for a day, if possible, because it appears you have some seriously wrong misperceptions of nursing, lab work, morphine, and physicians.
There are times when opiates can extend life, but it's also well established that opiates can and often does cause death and hastens death in the actively dying patient. Hospice and palliative care groups occasionally publish misleading articles to put caregivers, patients, and families at ease about the use of opiates at the end of life, but none of the evidence they use shows that it doesn't hasten death. What they are referring to is patients who need comparatively small doses to achieve comfort. There are also patient however who we are intentionally giving opiates to suppress the life sustaining efforts that are causing distress, most notably in the case of a terminal wean. The important thing to focus on is that ethically it's better to relieve suffering at the end of life when the outcome isn't going to change, only slightly altering the timing of it.
Thanks again for your advice :) . I have stayed overnight and in and out of a hospital with an aunt for 7 months before and with my grandma. Also I have a cousin who is a nurse... but I guess most of the fear comes from family members who have not taken medical studies sadly. For instance I remember my grandma's edema in her feet. And my family refused to acknowledge this. They kept saying it was caused by some kind of herb. And my grandma died like three times in the house, but was revived in cpr. Then when she died at the hospital all the family started saying she had a chance to live and it was because the hospital took off the oxygen that she died, others started saying it was because too much blood was drawn out, others say it was the change in her medicine. No one wanted to acknowledge the old age or that she was diabetic, she had stress issues, and was overweight. I think all they yelling from family attitudes and their lack of knowledge built in me a fear of hospitals. Ive been told since I was young the hospital is a place to die, where the student doctors are just practicing for the money etc etc. And the nurses are vampires. And for a while I started to believe that to hospitals we are just a number and not a patient.
But now I really want to bust all these myths my family instilled in me and begin to educate myself. My family is all on natural medicine and i like natural medicine too, but you need a balance of both alternative and medical areas of study. Whats the point on relying on natural herbs if one is already damaged organs in their body and need medical assistance at the hospital. Doctors arent out there to get us. I really wish to gain knowledge and not be in the dark anymore. So I apologize if my questions seem really negative or stupid. MY family is really supserstituous, phobic people and I dont want to be like that anymore. Reflecting on it now, my grandma wouldve died earlier if the paramedics didnt shock her or do cpr. Hospital staff really do save lives and they mean well. And I want to save lives too one day and be a great nurse. I really want to learn and am interested in cells and how the body works. I want to gain knowledge so that I can prevent my family from going to the hospital in the first place, and to be able to know what to do in case of an emergency. Thank you so much for your comments you always answer me. Thank you i appreciate it.
Nobody thinks you are stupid, I think there are some big misconceptions that you may have, and thank you for sharing why you have these thoughts. It's much easier to respond when we fully understand.
Nursing is a very complex job. You will be taught on what to do say if a doctor orders a wrong dose of medication. It happens. Doctors are human like the rest of us. No doctor gets up in the morning saying how can I harm my patients today? Neither do nurses. We all want to do our very best everyday. Doctors have an enormous stress load upon them and I would never want their job. Never. I can leave when I clock out. Somebody else takes over. Not so much for doctors. I see many who work a crazy amount of hours. No amount of money is worth what they give up in life. No amount.
If a patient is dying and say they are an organ donor, labs are drawn often. An organ cannot be donated if the body's electrolytes are off. Or if anything is off for that matter. Then, the nurse has to work to get that body at a good hemodynamic state. Labs are very important. They give us so much info on how that body is functioning. So much.
Morphine is a great drug for people who are dying. When you are dying and in pain morphine is very comforting. I know I don't want to spend my last moments on earth in excruciating pain. It's used as a comfort measure.
It sounds like your family was going through the grief process with your grandmother. There are 5 stages. Anger, Denial, Bargaining, Depression, and Acceptance. It's very common to place the blame on others. Natural remedies can be helpful, but pharmaceuticals are very important. Look at insulin. It allows diabetics to live now, where 100 years ago,the life expectancy was very short for them. There are so many ways medicine has completely changed our lives as humans. Hand hygiene for example was not practiced by even doctors 150 years ago. Now we think not washing our hands in everyday life is nasty. I'm sure you are getting my point by now.
Good Luck. I still highly recommend shadowing a nurse.
I'm going to differ here with Muno and agree with NightNerd. I'm a hospice nurse as well and we have patients on high (not "comparatively small") amounts of Morphine and Dilaudid for pain control and that isn't what kills them. In fact in some of the cases, it allowed them to get up out of bed and actually start living their lives to the fullest again. And they lasted months on the meds when at admit, some were curled into a fetal position, emaciated, and unable to move until their pain was controlled. I'd love to tell stories but it would just be anecdotal. Suffice it to say, I've never given Morphine or Dilaudid and had a person die because of it.
Even at end-of-life and respiratory distress, it can take hours and hours for a patient to die even when we give Morphine or Dilaudid or Ativan.
The idea that morphine kills people is what keeps people from signing up for hospice and hospice nurses and docs have been trying to educate the public about that for years.
There are times when opiates can extend life, but it's also well established that opiates can and often does cause death and hastens death in the actively dying patient. Hospice and palliative care groups occasionally publish misleading articles to put caregivers, patients, and families at ease about the use of opiates at the end of life, but none of the evidence they use shows that it doesn't hasten death. What they are referring to is patients who need comparatively small doses to achieve comfort. There are also patient however who we are intentionally giving opiates to suppress the life sustaining efforts that are causing distress, most notably in the case of a terminal wean. The important thing to focus on is that ethically it's better to relieve suffering at the end of life when the outcome isn't going to change, only slightly altering the timing of it.
Regarding your concern about morphine: as a hospice nurse, I just die a little every time someone says that morphine kills people. IT DOES NOT. Used appropriately, comfort care measures such as morphine have been shown to actually extend the life of terminally ill patients in some cases. Their bodies aren't being as worn down by pain, and they have a greater quality of life for their remaining time. I have had several patients who were breathing 40-50 times per minute (normal being 12-20) who received morphine (or Dilaudid, or whatever) specifically to decrease their work of breathing. If a patient's goal is to be comfortable at end of life, morphine is often a very helpful tool to meet that goal.
Natural remedies can be helpful, but pharmaceuticals are very important. Look at insulin. It allows diabetics to live now, where 100 years ago,the life expectancy was very short for them. There are so many ways medicine has completely changed our lives as humans. Hand hygiene for example was not practiced by even doctors 150 years ago. Now we think not washing our hands in everyday life is nasty. I'm sure you are getting my point by now.
Good Luck. I still highly recommend shadowing a nurse.
Yes of course! I remember all the time modern medicine has helped me. For example getting my tonsils removed helped my sinuses. Then the z-pak got rid of a severe bronchitis infection( I happened to get it, because the car heater filter was not clean, and the previous owner used to smoke in it alot) I was dying from the bronchitis, and I did alternative medicine, which helped a bit- but its the zpak that got rid of it! I'm always amazed and thankful for it. Then a doctor cured a menorrhagia problem with birth control pills I had due to high levels of stress-from family issues lollll. So I am very thankful for pharamcetuicals thankgod.
I'm going to differ here with Muno and agree with NightNerd. I'm a hospice nurse as well and we have patients on high (not "comparatively small") amounts of Morphine and Dilaudid for pain control and that isn't what kills them. In fact in some of the cases it allowed them to get up out of bed and actually start living their lives to the fullest again. And they lasted [i']months[/i] on the meds when at admit, some were curled into a fetal position, emaciated, and unable to move until their pain was controlled. I'd love to tell stories but it would just be anecdotal. Suffice it to say, I've never given Morphine or Dilaudid and had a person die because of it.
Even at end-of-life and respiratory distress, it can take hours and hours for a patient to die even when we give Morphine or Dilaudid or Ativan.
The idea that morphine kills people is what keeps people from signing up for hospice and hospice nurses and docs have been trying to educate the public about that for years.
You know spidey mom, I remember my family and I rejecting the morphine for my grandma, because we were genuinely scared of losing her from it, because we read about all the bad side effects and because we wanted her alert for her last moments. Even my nurse cousin kept shrieking at the doctors not to give the morphine to my grandma.....and i remember my grandma her legs were peeling and bursting from the edema and it was burning her she was in pain, and the doctors and nurses would just wrap them up, until my cousin nurse told them to put zinc oxide on them which helped a bit.....I remember crying for hours straight when the doctor told me her kidneys were shutting down....now that I think about it....i wonder if it wouldve been better to give her a small dosage of the morphine....I dont know why we all expected some kind of miracle to happen and she be better again...but because my family believed this i believed in it too.....but she kept turning blue everytime she lied down..........its painful to remember, but her face glowed at peace when she died :'(
You know spidey mom, I remember my family and I rejecting the morphine for my grandma, because we were genuinely scared of losing her from it, because we read about all the bad side effects and because we wanted her alert for her last moments. Even my nurse cousin kept shrieking at the doctors not to give the morphine to my grandma.....and i remember my grandma her legs were peeling and bursting from the edema and it was burning her she was in pain, and the doctors and nurses would just wrap them up, until my cousin nurse told them to put zinc oxide on them which helped a bit.....I remember crying for hours straight when the doctor told me her kidneys were shutting down....now that I think about it....i wonder if it wouldve been better to give her a small dosage of the morphine....I dont know why we all expected some kind of miracle to happen and she be better again...but because my family believed this i believed in it too.....but she kept turning blue everytime she lied down..........its painful to remember, but her face glowed at peace when she died :'(
I'm very sorry. Your grandmother would have benefitted from pain relief. You can't go back and change that but you can go forward in your nursing career using that as a learning experience.
That knee-jerk reaction to Morphine and other drugs is what hinders hospice from helping people at the end of their lives.
I'm so sorry this was your experience. It is true that narcotics often make people more lethargic, and this is a very common concern. It's important to consider what the patient wants at end of life, even when as a loved one, a nurse, or a doctor, we may have very strong opinions about what is right. I always ask my patients and their families to define "comfort" when I first met them. I have had plenty of patients who are willing to endure some amount of discomfort to be alert for a longer period, and I respect their wishes. But, when a patient tells me that they want to be out of pain, even if the medication makes them less alert, and their family hears then tell me this, it keeps the goal of care clear for everyone involved.
I'm impressed that you are taking these very intense personal experiences and using them to learn. This is the sort of attitude that will help you be a compassionate nurse, if this is what you choose as a career.
I'm going to differ here with Muno and agree with NightNerd. I'm a hospice nurse as well and we have patients on high (not "comparatively small") amounts of Morphine and Dilaudid for pain control and that isn't what kills them. In fact in some of the cases it allowed them to get up out of bed and actually start living their lives to the fullest again. And they lasted [i']months[/i] on the meds when at admit, some were curled into a fetal position, emaciated, and unable to move until their pain was controlled. I'd love to tell stories but it would just be anecdotal. Suffice it to say, I've never given Morphine or Dilaudid and had a person die because of it.
Even at end-of-life and respiratory distress, it can take hours and hours for a patient to die even when we give Morphine or Dilaudid or Ativan.
The idea that morphine kills people is what keeps people from signing up for hospice and hospice nurses and docs have been trying to educate the public about that for years.
I'm sorry if this is a derail, but I just wanted to nod my head in agreement with Spidey'sMom. We often have CMO patients on our floor and while the hospice nurses will say we aren't quite as liberal with the morphine/ativan/dilaudid as they normally would be, I have never, in my 2 years, have had a pt die directly after a morphine administration. Even on a morphine drip (not PCA, actual drip) the pts are less restless, agitated, grimacing/moaning, calling out, crying. The load of severe pain is lifted off their shoulders, and after the pt has found some relief you can see family just ease down from their panic. But they have never just up and given the ghost. To say that we are misleading the public worth false studies is horrendous.
Op, shadow a nurse. Read the job labor outlooks in your area. Check what is needed to get into college on your area. Observe on AllNurses. Nurses are not infallible saints (see your cousin (?) and others) nor are they angels of mercy or death. You sound like you're on the right path, but don't be surprised if your family alienates you if you pursue nursing and adhere to the more scientific, rational approach to healthcare - a generationally-entrenched belief system does not tolerate dissent well.
I'm so sorry this was your experience. It is true that narcotics often make people more lethargic, and this is a very common concern. It's important to consider what the patient wants at end of life, even when as a loved one, a nurse, or a doctor, we may have very strong opinions about what is right. I always ask my patients and their families to define "comfort" when I first met them. I have had plenty of patients who are willing to endure some amount of discomfort to be alert for a longer period, and I respect their wishes. But, when a patient tells me that they want to be out of pain, even if the medication makes them less alert, and their family hears then tell me this, it keeps the goal of care clear for everyone involved.
Thanks for adding this, especially the bolded part.
PrincessNur
18 Posts
Thank you NightNerd, I really liked your details and I will shadow a nurse. As I stated I have grown up with superstitious family members who lack medical experience. And my cousin nurse is always grumpy and I believe to be bipolar. I dont know how she is still working as a nurse. She once told me that doctors order lots of blood from anemic patients so they can give another patient the room. But then again I dont know why I listened to her, when she takes l ike 20 different vitamin pills on an empty stomach each morning and tries to encourage me to do the same. I believe I will find much relief when I begin my nursing education. I am done with these stupid horror stories ppl tell me. I cant wait to become educated.