by Karin Swendsen

Nursing

Mrs. Hansen, an 84-year-old resident of New Horizon Nursing Home, was diagnosed as having a Stage II carcinoma of the breast six months ago. She was given the options for treatment, including lumpectomy followed by radiation and chemotherapy. The day before her scheduled surgery, she told the nurse she had decided to cancel the surgery, radiation, and chemotherapy, stating that she has lived a good life and is ready to die. She does not want to suffer all of the misery and expense of the treatment to prolong her life.

Laura, a Licensed Practical Nurse, has just started working at the New Horizon Nursing Home. During the night shift, she finds Mrs. Hansen in extreme pain. Laura checks Mrs. Hansen's chart, and notes that the medication order is for Morphine Sulfate, which is on a sliding scale and is to be given"I.V." for pain. Soon Mrs. Hansen's screams can be heard down the hall, and she begs Laura to help her.

Laura is the only nurse on the night shift, and is in charge of thirty-five patients. She knows she is not licensed to administer narcotics, but she has seen her supervisor, who is a

Registered Nurse, give the Morphine I.V., and thinks she could do it. Mrs. Hansen needs to be relieved of her suffering.

Questions:

What should Laura do? She could lose her job and her license for performing treatments outside her legal authority.

What would you do?

Does Mrs. Hansen have the right to refuse treatment that will prolong her life?

Do the other patients have the right to undisturbed sleep?