Ms. Green’s resident and nurse sit to talk with Ms. Green and her daughter about their concerns. They first ask if there are aware of any other family members (besides Ms. Green’s brother) who have used opiates, either prescribed or illicit. Ms. Green’s daughter explains that one of her nephews was addicted to pain killers he bought on the street.
The resident and nurse educate Ms. Green and her daughter about safety of opiate use for patients in pain, explain that in these circumstances addiction is extremely rare and that morphine is not just for people who are dying and it will not hasten her death. Patient and daughter are reassured.
After leaving the room,
Nurse: “I don’t think her daughter realized how sick she really is. Does she have options for more chemo? The way she looks now, I’m not sure she could take any more anyway. Maybe we should have a family meeting to go over where things are headed.”
Resident: “I’m not sure if there are any options left for her. We should speak with her oncologist. I’ll speak to my attending about a family meeting. Thanks.”
Nurses are key in assessing the coping style of the patient and family, assisting in decision making and helping to educate the patient and family.