8 milligrams

8 milligrams. thats how much morphine it takes to kill somebody.

specially if you're an old Mr. Kantbreathe with lung disease that is ready to go, who has a family that is ready to let go, whom God is ready to receive.

course, it wasn't me that did it. i kinda wish it was, you see, 'cept i didn't know how. i had this dood all night, and just barely kept him alive, with smaller doses of morphine to 'fight air hunger.' morphine does that, you know. it just knocks down your drive to breathe-give enough and you just, you know, sorta stop breathing. so while the order read 2 to 8 mgs morphine q hour, i only gave 4 at a time. shoulda given the whole dose.

which is what the more experienced nurse who followed me did. i asked him about it when i came back that night. i gave report, splained to him the situation, and 1 hour later, Mr Kantbreathe was released from his earthly bounds and sent onward.

how did you do it?

i just gave the full dose.

really?

yeah, sure. most of my patients that have died on me are lung disease people. i explain that the scar tissue that is built up in the lungs just isn't allowing the lung to do what they are supposed to, which is why Dearly Beloved is working so hard to breathe. if their heart doesn't give from beating 100 times a minute for DAYS, think of how exhausted they are from breathing 30 to 40 times a minute.

(for those of you keeping track at home, thats a lot. like, a lot a lot. try it; sit down, get comfortable, and breathe 40 times a minute. through a coffee straw. see how long you last.....)

how do you start that conversation?

first thing i do is ask 'what did the doctor tell you?' and take it from there. then i show the family the orders, and explain that they were written to give the patient comfort, and that i am comfortable doing whatever the family wants to make the pt not suffer. 8 mgs is actually not very much, comfort measure orders are usually, like, 10-15 of morphine plus 2 of ativan, it really relaxes the muscles and helps ease up the process.

well, i know that there was nobody left that needed to say good-bye.

yeah, the family was ready, and the poor guy.......he was ready, too.

well, now i know for next time. if i'm brave enough, or courageous enough.