Anyone deal with an overzealous nurse?

Both my parents would have extreme hallucinations on morphine- so we avoided it. However, towards the end, when my father was on hospice, suffering from CHF and his lungs were filling with fluid, I agreed to morphine as they told me it would help his breathing. Daddy was also given Ativan with the morphine and that seemed to help with the hallucinations- who knows, perhaps he was still having them but with the Ativan he didn't care? I am also sorry you're having to go through this. Seeing a loved one struggle for breath is gut wrenchingly heart breaking.

Hang in there stressed - I believe some folks are also allergic to morphine - I believe my mom is so I pray she will never need it

Let us know how the procedure goes tomorrow

Oh, Stressed, I'm so sorry that this isn't going well!

Thank you Pam. I did in fact see my mom really struggle and it did push me. Seeing it and hearing about it are two different things aren't they? Thanks again

Thanks Veronica, for answering, and with your own experience. To answer and update; Everyone was pretty sure the drain was in the wrong place because it was only dripping a little blood (tbsp daily) and not the 1.2 liters of fluid that normally would come out. Also, it was obvious that she couldn't breath due to the fluid building. Today they finally took her to radiology and confirmed that the drain was in the wrong area and she indeed has a large amount of fluid. (The SNF is attached to the hospital here so it's just down the hall) Because a different hospital put the drain in this hospital won't touch it to put it in the right area OR remove it. The nurse made an appt to take her back to the other hospital again and I said No. No more. I don't like the other hospital, they screwed it up already and it's just too much for Mom to go thru that again. Unfortunately, for whatever reason, the radiologist didn't remove the fluid while he had her in there today, don't ask me why, maybe the order wasn't clear, so it's scheduled for tomorrow morning. Her Dr said she can probably remove the drain herself so we planned on her doing that, plus removal of the fluid and some IV meds to deal with high calcium levels. (The Lasix was working but now it's thrown too much off balance) Dr wants to see how she does after thoracentisis and lowering the calcium and that's fine, but we also agreed that the morphine is there if her quality of life doesn't return. SO, then tonight she was so miserable with all that fluid that I asked Hospice for the Morphine. I thought if this is it then let her be comfortable. It was the exact OPPOSITE of what I expected. Who knew? It did not comfort her, did not ease her breathing, did not relax her! She was just as distressed but now it was LOUD. Like an unruly drunk :-/ Well that was a cherry on top huh? Here all this time I've worried about them overmedicating her with the morphine and it turns out to be party drug of choice for my 96 yr old mother! She went from laying in bed with her eyes closed struggling and miserable, to sitting in a chair wide eyed and yelling and miserable still struggling to breath. I asked for some Xanax to get her to sleep. Tomorrow is another day and hopefully the thoracentisis will help, and then we can put together a different strategy for comfort. I'm sure they have other drugs besides morphine. I hope I am able to help someone else with this knowledge that morphine affects some people differently. And I'm super glad I wasn't doing this at home on my own. Now it's time to find out what DOES work when she needs it. Thanks again 😘

"really struggling" is the phrase they used when my MIL was very close to death. We saw it happening, gasping, kicking, moaning. She could not wake up, we could not feel a pulse. So go there and see it for yourself, it may lead you to OK the roxanol. We did.

Stressed how do you know the plurex is in the wrong place? Have they tried to drain it? It is probably beyond the scope of an SNF to drain a Pleurex. Not really difficult but they often won't take it on.
Your nurse may be new or overly aggressive but he probably knows that once fluid keeps recurring it tends to come back very frequently like daily. Are they giving her strong enough diuretics. I had what is called a pigtail when I was in heart failure for a few days and they drained a great deal of fluid through that. they were going to put in a pleural but said there was too much risk of infection with a permanent drain so they just removed the pigtail and stepped up the Lasix IV which worked pretty well. The nurse wants to give Mom the morphine because it will ease her feeling of breathlessness so she is more comfortable. of course the Zane is for anxiety and everyone is anxious when they can't breath.
If you feel Mom is close to death my decision would be to encourage the morphine and although it won't hasten death will certainly keep her a lot more comfortable. By the way a Pleurex is not difficult to remove and can be done by a Dr in the SNF. Much easier to take out than put in. if you think Mom may have some time left it might be worth replacing the pleurex so the fluid can be drained daily. it is a very simple painless procedure. they just put a vacuum bottle attached to the tube and the fluid runs into that. A lot depends on the reason for the fluid build up and how close to death the family and Drs feel rather than what Mom hopes will happen. Repeated thoracentesis can be distressing and exhausting. Hope this all works out for you. You need to question Mom's Drs and get their honest opinion on Mom's prognosis.

Thank you for answering Babalou. Her doctor wanted a Pleurex drain put in to alleviate all the pokes because mom is in NO pain otherwise and she felt she had months still to live. We had to travel to a different hospital 40 min away to have it done. The Dr put it in the wrong place and now she has a drain that OUR hospital won't touch and she still needs to have the fluid drained. I don't want to drag her down to that hospital again to have it removed! As of last night this whole thing feels like a circus. Her Dr ordered an infusion because her calcium is way high and affecting her mental status. Hospice keeps saying they don't 'hasten' death which is what's making this so hard. I just want her to have the fluid drained so she's comfortable and THEN be let go. Does that make sense? If they would just word it like that I'd be on board. Has your Mom passed? I signed up with the Hospice and all they did was take her off of baby aspirin and vitamin D. Then the fluid built up and she's miserable. I don't want to see her in misery. I want to ask them to just give her enough morphine to let her go but it seems that they just aren't doing that. I know it's time for her to go but we can't seem to get on the same page. I'm just so frustrated. Thanks for listening. I'll give her doc a call and see if we can't move forward in a better way. Thanks

Stressed, is mom on Hospice? Is Hospice on board with getting fluid drained frequently?

We went through this with my mom about a year ago. After her chest had been tapped several times ( including one situation where, as mom's lung reinflated, a pocket of bacteria " bloomed", sending her into septic shock) we sat down with her pulmonologist, who said to me " stop poking holes in your mother. The next time this happens, call in Hospice, get her on morphine and let her down gently".

That is what I'll do.