Not long ago I was contacted by a nurse manager regarding one of her nurses, Q. It seems Q had been the nurse caring for a patient who was dying and she was experiencing some distress. Shortly after Q administered the prescribed dose of narcotic for the patient, the patient stopped breathing. Q worried that she had somehow hastened the patient’s death. I met with Q, and we talked about what had happened.
As Q told her story, it was clear she had used appropriate indicators in her assessment that the patient was suffering. The dose she administered was well within normal prescribed doses. She administered it in the routine fashion.
As we talked I did my best to reassure Q that the timing of the patient’s last breath was simply a coincidence. By the end of our discussion, Q was clear in her mind:
In her heart however, Q still believed it would violate her ethics to participate directly in the care of dying patients.
Clarian has a policy that supports employees who feel they are unable to participate in certain treatments or types of patient care due to their cultural values, ethics or religious beliefs. Does your facility have a policy like this?
There are limits to an employee’s refusal to participate in certain types of care. As in Q’s case, however, if the employee approaches their manager and discusses their concerns in a professional respectful way, there is a clear process to follow to ensure that Clarian’s patients receive safe care, and, whenever possible, our employee’s personal ethics are supported.
Lucia Wocial, PhD, RN
Clarian Health Nurse Ethicist
To join the Registered Nurses at Clarian, visit Registered Nurse Job Opportunities
As Q told her story, it was clear she had used appropriate indicators in her assessment that the patient was suffering. The dose she administered was well within normal prescribed doses. She administered it in the routine fashion.
As we talked I did my best to reassure Q that the timing of the patient’s last breath was simply a coincidence. By the end of our discussion, Q was clear in her mind:
- Her intent was to alleviate pain.
- Alleviating pain and suffering at death is a good thing.
- While narcotics may cause respiratory suppression, the need to alleviate the pain is more compelling than the potential for respiratory suppression.
- She did not intend to alleviate the suffering by causing respiratory depression.
In her heart however, Q still believed it would violate her ethics to participate directly in the care of dying patients.
Clarian has a policy that supports employees who feel they are unable to participate in certain treatments or types of patient care due to their cultural values, ethics or religious beliefs. Does your facility have a policy like this?
There are limits to an employee’s refusal to participate in certain types of care. As in Q’s case, however, if the employee approaches their manager and discusses their concerns in a professional respectful way, there is a clear process to follow to ensure that Clarian’s patients receive safe care, and, whenever possible, our employee’s personal ethics are supported.
Lucia Wocial, PhD, RN
Clarian Health Nurse Ethicist
To join the Registered Nurses at Clarian, visit Registered Nurse Job Opportunities
Powered by Compendium Blogware
Comments for A Registered Nurse Needs Reassurance, Too