Unbelievable! Bravo to this employee! I am a nurse, old school, and have been for many years and cannot begin to imagine what this hospital's medical staff who had direct contact with Seth Rich must have gone through and the scars it has left. I know that the saying, "Never say never," holds true before whatever it is happens, but physicians are bound under the Hippocratic Oath, "First, do no harm." So, what would a doctor do if compromised and knowing or suspecting that their own lives would or could be at stake? There is a new generation of health care providers today, and nothing comes anywhere near to the dedication, compassion, and integrity that once existed. Of course, this does not pertain to all, but the lack of these traits rarely existed in the past. If I was involved in a similar siuation, regardless of the compromise particulars, one must put the patient first, always without exception, but you also must feel that way in your heart. The next step would be the submission of my resignation.
No, that is not true. The drug of choice in terminally ill patients is normally morphine. Morphine is also used in many other instances as well, but I am just addressing a very ill person who is not expected to live. The most important thing is to keep a patient pain-free and agitation-free. Doses of morphine are titrated up and down based on many factors - for example, if conscious, what are they telling you; if unconscious, are there signs of restlessness or agitation; has their heart rate, blood pressure increased. Regardless, no two patients are the same. Each patient is to be evaluated as an individual. Morphine comes in many forms and concentrations. For the terminally ill, it is usually administered via an intravenous pump according to physician orders. For all opioid drugs, there is no ceiling effect (refers to the dose beyond which there is no additional pain-relieving effect, i.e., higher doses do not provide additional pain relief but may increase the chance of side effects). Relieving pain, even if it hastens death of a terminally ill person, is considered an ethical and moral obligation of a nurse. It is not euthanasia or assisted suicide. Unfortunately, patients have been known to say that inadequate pain relief and intolerable suffering are reasons to seek assisted suicide. We, as nurses, are not permitted to participate in assisted suicide or euthanasia. It is in violation of the Code for Nurses. We do, however, have a responsibility to provide pain-relief and to make referrals to appropriate professionals when a patient's wishes conflict with a nurse's professional sense of morality. Hope this adequately answers your question.
Relievong pain, even if it hastens death of a terminally ill person, is considered thr ethical and moral obligation of a nurse. It is not euthanasia or assisted suicide.
This is a very very fine line, and it sounds too close for comfort.
I'm sure you're a "good guy" but I have seen this excuse used when what was going on was obviously euthanasia. It happened to my grandmother, she couldn't communicate, the family gathered 'round to see her die, doctor came out to the house and gave her a dose and we sat and waited.
Edit: I've also seen what you're talking about, my sister-in-law asked for more morphine due to pain (cancer) though her husband warned it might kill her (he was in charge, this was the UK) ... she just said "but how do we know?" She was too "inebriated" from the present dose in her body that I highly doubt she was thinking right. I'm afraid this is tough issue and not as black and white as we would all like.
I very much appreciate your professional input, info, opinion, I really do.
I hear what you are saying, let me explain a little bit more. All opioids can cause a decrease in vital signs - respiration, heart rate, and blood pressure. For example, a person is in their last stages of life, meaning it is obvious to doctors and nurses that the end is near which is determined by monitoring the clinical signs and symptoms over whatever period of time. Say the patient appears to be comfortable. Then there is no reason to titrate upwards. 3 hours later, the patient is crying out, perhaps thrashing in the bed, etc. Maybe the patient can verbalize, maybe not. That is where effective evaluation and judgment must enter. A decision is made to titrate upwards (which by the way is always in small increments) and the patient is now at rest. Medicine is a science. Taking care of the terminally ill and any patient for that matter requires good judgment and common sense. If a medical professional lacks these qualities they are a danger to their profession and to their patients.
Thanks for that. I wouldn't want to be in your/their shoes. I know all about opiates unfortunately. And Narcan. Unfortunately. And hospital heroin. Unfortunately.
I am glad to hear that, and I am so sorry about your grandmother. Of course, I am unable to comment on her particular situation without being there or knowing her. My parents both died at home, terminally ill from cancer, both with morphine and hospice involvement. I will always be grateful in having the opportunity, although heart-wrenching, to be there with them 24/7 for the last days of their lives
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13Buddha ago
Unbelievable! Bravo to this employee! I am a nurse, old school, and have been for many years and cannot begin to imagine what this hospital's medical staff who had direct contact with Seth Rich must have gone through and the scars it has left. I know that the saying, "Never say never," holds true before whatever it is happens, but physicians are bound under the Hippocratic Oath, "First, do no harm." So, what would a doctor do if compromised and knowing or suspecting that their own lives would or could be at stake? There is a new generation of health care providers today, and nothing comes anywhere near to the dedication, compassion, and integrity that once existed. Of course, this does not pertain to all, but the lack of these traits rarely existed in the past. If I was involved in a similar siuation, regardless of the compromise particulars, one must put the patient first, always without exception, but you also must feel that way in your heart. The next step would be the submission of my resignation.
bopper ago
Is it not true that they are "euthanizing" patients w/ morphine more and more? Those who are deemed to be close to death anyway?
13Buddha ago
No, that is not true. The drug of choice in terminally ill patients is normally morphine. Morphine is also used in many other instances as well, but I am just addressing a very ill person who is not expected to live. The most important thing is to keep a patient pain-free and agitation-free. Doses of morphine are titrated up and down based on many factors - for example, if conscious, what are they telling you; if unconscious, are there signs of restlessness or agitation; has their heart rate, blood pressure increased. Regardless, no two patients are the same. Each patient is to be evaluated as an individual. Morphine comes in many forms and concentrations. For the terminally ill, it is usually administered via an intravenous pump according to physician orders. For all opioid drugs, there is no ceiling effect (refers to the dose beyond which there is no additional pain-relieving effect, i.e., higher doses do not provide additional pain relief but may increase the chance of side effects). Relieving pain, even if it hastens death of a terminally ill person, is considered an ethical and moral obligation of a nurse. It is not euthanasia or assisted suicide. Unfortunately, patients have been known to say that inadequate pain relief and intolerable suffering are reasons to seek assisted suicide. We, as nurses, are not permitted to participate in assisted suicide or euthanasia. It is in violation of the Code for Nurses. We do, however, have a responsibility to provide pain-relief and to make referrals to appropriate professionals when a patient's wishes conflict with a nurse's professional sense of morality. Hope this adequately answers your question.
bopper ago
This is a very very fine line, and it sounds too close for comfort.
I'm sure you're a "good guy" but I have seen this excuse used when what was going on was obviously euthanasia. It happened to my grandmother, she couldn't communicate, the family gathered 'round to see her die, doctor came out to the house and gave her a dose and we sat and waited.
Edit: I've also seen what you're talking about, my sister-in-law asked for more morphine due to pain (cancer) though her husband warned it might kill her (he was in charge, this was the UK) ... she just said "but how do we know?" She was too "inebriated" from the present dose in her body that I highly doubt she was thinking right. I'm afraid this is tough issue and not as black and white as we would all like.
I very much appreciate your professional input, info, opinion, I really do.
13Buddha ago
I hear what you are saying, let me explain a little bit more. All opioids can cause a decrease in vital signs - respiration, heart rate, and blood pressure. For example, a person is in their last stages of life, meaning it is obvious to doctors and nurses that the end is near which is determined by monitoring the clinical signs and symptoms over whatever period of time. Say the patient appears to be comfortable. Then there is no reason to titrate upwards. 3 hours later, the patient is crying out, perhaps thrashing in the bed, etc. Maybe the patient can verbalize, maybe not. That is where effective evaluation and judgment must enter. A decision is made to titrate upwards (which by the way is always in small increments) and the patient is now at rest. Medicine is a science. Taking care of the terminally ill and any patient for that matter requires good judgment and common sense. If a medical professional lacks these qualities they are a danger to their profession and to their patients.
bopper ago
Thanks for that. I wouldn't want to be in your/their shoes. I know all about opiates unfortunately. And Narcan. Unfortunately. And hospital heroin. Unfortunately.
I'm OK now though. Fortunately.
13Buddha ago
I am glad to hear that, and I am so sorry about your grandmother. Of course, I am unable to comment on her particular situation without being there or knowing her. My parents both died at home, terminally ill from cancer, both with morphine and hospice involvement. I will always be grateful in having the opportunity, although heart-wrenching, to be there with them 24/7 for the last days of their lives
bopper ago
Wow. Thanks again.