Hospice Nurse argued with me about my father's Directives to not supply oxygen or inhalers for his breathing, I had to go over her head.
90 yr old late stage ALZ and Dementia father. In a care center. Multiple health issues: COPD, asthma, black lung, multiple bed sores that stay infected over 4 months now. two broken hips in the last 19 months, last hip could not be repaired. Couldn't walk before the hip breaks. Failure to thrive. Lost 60 pounds the past year, barely eating or drinking. Cyanosis (blue) hands most of the time. Poor cardio vascular health. Bed ridden for months, cannot support himself out of bed one bit. ZERO short term memory. Atherosclerosis vascular disease in both legs. If he sits up in a wheelchair just a few minutes, his feet turn purple from the vascular disease but pink back up once horizontal in bed. Peripheral neuropathy both feet. And more.
Went under Hospice 30 Mar 2015.
His signed health directives state on one section that if he suffers from breathing difficulties, take no action, make him comfortable, no oxygen, etc.
He had a bad asthma attack last week Wed 29 July 2015 , the Hospice Nurse called me and gave me a very visual description (which was cruel IMO to have to picture his distress) of how he was and insisted I give her permission to administer oxygen, nebulizer, inhalers. I said 'no'. she wanted to argue with me. 'No'. Hospice Nurse then tells me, 'I have a 93 yr old father and I know what I'd do if he was in this state'. I'm telling her 'you are a Hospice Nurse, right? He's dying which is why he is under Hospice care. He has signed directives in his chart, NO oxygen. Give him morphine per the Hospice Care Plan to help make him comfortable. She wanted to argue. I cut her off.
She then told me 'I told the doctor you would not agree, so doctor asks that you call her ASAP and discuss, then please call me back'. Hmmmm, okay.
So I called the doctor, who was an on-call doctor who had never seen my father, never seen his chart, wasn't familiar with his case. I explained the why's and his wishes. Doctor tells me that she wasn't briefed on any of this, just had a call from Hospice Nurse saying he needed oxygen and inhalers so she approved the treatment as a standard protocol. On-call doc was 4 hours from the care center.
On-call doctor agreed with me after hearing his complete medical history and said she agreed with me. I called Hospice Nurse back. told her what the on-call doctor said.
Hospice Nurse STILL wanted to convince me to give him medical care. She again went into the 'if you could see how he was clutching at my hand, begging me to help him, it broke my heart....".
I again refused to administer oxygen, etc..
She said she had started morphine care plan to ease his breathing and it was helping SOME but he needed oxygen. I said NO.
I told Hospice Nurse that I was on my way, it would take an hour to get dressed and get there. When we got there, she had left 15 minutes prior.
My father was sitting up, not laboring for breath, didn't even remember he had been wheezing or pulling for breath, didn't remember the nurse being in his room for over an hour. So he was fine.
Next morning same Hospice Nurse called me and I told her 'thank you for taking care of XXX but it seems the morphine did the trick and the oxygen and inhalers were really not needed' and that started yet another argument.
Hospice Nurse then tells me that she is turning this over to her Operations Manger and I would be getting a call from her. And I did. And we talked for over an hour.
I voiced my concerns about the nurse comparing what she would do for her father versus what my father's health care directives read, I am following his orders. I told her I would sue for emotional distress due to being told over and over the very descriptive status of my father begging for help and clutching the nurse's hand...that I felt like she was trying to guilt me.
After our conversation, she sided with me 100%, she was not familiar with my father's medical history and his wishes.
She immediately changed his care plan to no oxygen, etc., and had it signed by my father's doctor.
He has since had another asthma/wheezing attack which was handled by morphine. And was fine the next morning.
The same Hospice Nurse is now siding with me and agreeing with the new care plan.
But the stress of having to deal 2 full days of numerous phone calls, arguing, not being HEARD took a toll on me, mercy.
When you say 'no', why is that not enuf?
That said it is unfortunate that you had to deal with this, I'm glad you were able to make your voice heard.