Her mom is my client. She has cold and bad congest, plus she has COPD. I have been with her almost 6 years and had worked with Hospice nurses many different cases ...But my client's daughter wants to give Mom for Morphine to make her comfort... I do personally think It is wrong.

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STP, do bear in mind that morphine is not only used for pain relief. I know this is counterintuitive, and you hear a lot of suspicious grumbling about it in the media, but morphine is also effective in improving the *quality* of a person's breathing - honestly, this is true; I questioned it myself when my mother's GP first introduced the idea of offering it to her; but if you want to understand how it works you should be able to find explanations online quite easily.

Seeing as your client has had this nasty cold and chest congestion, I would be pretty confident that she is being given the morphine #1 to help her breathing and #2 to relieve the discomfort you get from this (I've just had it myself - it feels like a badly pulled muscle or a stitch - not agony, but certainly not very nice at all).

So I hope that's reassuring. But, is there anything else about the way your client is being given morphine that is making you anxious?

I don't agree that a professional caregiver should keep silent about anything that isn't part of her personal job description. Protection of vulnerable adults actually requires the opposite, that anybody who witnesses treatment of an elder that they're not comfortable with should speak up; and arguably a professional caregiver has an additional duty of care to her client. What's more, you've been looking after this lady for six years and I think you deserve to have your experience of her normal habits respected.

I certainly don't see anything wrong with your questioning the morphine dose if it seems to you that it is being given incorrectly. Be polite, don't argue, don't accuse, and certainly don't try to overrule a family member who is following medical instructions; but there is nothing wrong with asking.
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Whoa! Let's see where STP is coming from before we "throw her under the bus".

(For those of you who would question my post, I am a hospice nurse and I don't have any problem giving Morphine.)

STP, what are you worried about regarding the morphine?
That C will die?
That her daughter will give her too much?
That she'll become addicted?
Did you or another patient have a bad experience with Morphine?
Did your family member take it and something bad happened?
Are you worried she will stop eating?
Have you heard that Morphine can kill people?
Probably, in C's case, because she has COPD (chronic obstructive pulmonary disease), she has a hard time "catching" her breath. She probably struggles a little to get the air in and out, right? That's why they give her oxygen. Then the level of oxygen in her blood goes up and she can breathe a little easier.
Well, the Morphine is ALSO used to help her breathing. It calms her down and helps her muscles relax so she doesn't struggle (and use up a lot of oxygen) just to breathe. It relaxes the breathing muscles.

Morphine is a narcotic and is also used for pain. It doesn't sound like C has any pain. So it's not being used for that.

It's too bad that this wasn't explained to you by C's daughter but I guess she didn't think about it.

Please be reassured that the Morphine is used to help C breathe easier. It doesn't sound like the medicine is harming her in any way.

Even though you can not say or do anything about the situation, you can be concerned about it.

I hope this has made it clearer to you.
Helpful Answer (8)

When my mom was on hospice, they gave me morphine to give to her. I told the nurse mom wasn't in pain and she explained that morphine would help my mom breathe more easily. My mom had increasing lung stiffness (pulmonary fibrosis). The nurse said it relaxes the nerves in the lungs (or sends messages to the brain, I can't remember which) so that the person doesn't struggle to breathe. So I imagine your client's daughter is wanting to use it to ease her mom's breathing.
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It sounds like you think the morphine will mean she will die sooner. Is that what you're thinking? That's not my experience. It just means she'll be more comfortable.
Helpful Answer (6)

Totally agree with the explanations about the use of morphine for breathlessness. It really does improve the quality of life for the patient. It means they can continue to eat well, get around in the house and this can be a biggy actually get to the bathroom. They are also able to go out, get to Dr appointment and enjoy family gatherings and celebrations. it is usually given using a tiny string without a needle so there is no discomfort involved. It is given slowly into the mouth and may taste bitter so it is a good idea to follow with a small flavorful drink.
There is absolutely no need to be concerned about addiction. Even if this should happen the patient will need it for the remainder of their life anyway. There is a big differnce between dependency and addition. For example someone can be dependent on insulin if they are diabetic but they are not addicted. Likewise the morphine allows them to live longer more comfortably and the doses needed are minute for breathlessness..
Many Hospices do provide a comfort kit when a patient is admittedbut it is not to be used without the advice of the Hospice RN. This is an emergency kit and only contains a very small amount of medications that can be used in an emergency. It allows the RN on call to administer medications that may be needed urgently when crisis arrises when all the pharmacies are closed. They are part of what are called standing orders that allow the RN to administer drugs that normally are only ordered by a physician for usually one time till a Dr can be contacted and further presciptions ordered.
Comfort kits are not an endless supply of narcotics that can be given at will. They are for emergency use only. If a POA feels there is something about her charge that needs attention she is perfectly free to make a request about using medications..
You have done a fantastic job taking such good care of the client for 6 years and your team is to be highly commended.
But look at it this way if you were an EMT taking care of someone trapped in a car having to be cut out which will take time and they are in excrutiating pain wouldn't you choose to use morphine if you had it in your ambulance and were authorized to use it at your discretion?. Well your client is trapped in her own body and morphine will help her with her struggle to breath easier. She needs both the oxygen and the morphine.
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Agree -- you are not her DPOA so you should keep quiet. If you personally think it is wrong, that is, if you have ethical concerns with it, perhaps you should seek a position where that isn't happening, and let them get someone who is comfortable with comfort measures.
Helpful Answer (5)

Thank you everyone, my C is doing VERY fine now, I don't have to use O2 or Morphine!!! I do not brag about my care for C... My other two caregiver think my thought a same as they do! I wish I could send you a nice picture of her with big SMILE!!!
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All's well that ends well, I guess. 😀
Helpful Answer (3)

Has a doctor or advanced practice nurse prescribed the morphine? If not, where is the daughter getting it from? If the daughter want's to talk to someone to see if a prescription would help or it, it think it's her business.
Helpful Answer (2)

Keeping her comfortable is not the wrong thing to do. Overstepping the bounds of your job will not help anyone, included you.
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