Methadone is the second choice of pain relieving medication in the comfort kit (see comfort kit). This medication is used when a person has an allergy to morphine. We use it in hospice care as a pain reliever. The medication prolongs the QT interval and poses a risk to dysrhythmias. It should be monitored closes to patients who have cardiac issues. It is recommended that all patients received a ECG prior to treatment 30 days before and annually afterwards. All patients should follow the prescribed amount, if exceeded, they are at risk for an overdose. Although the medication has a stigma to it, it is important to note for the purpose of hospice or palliative care we use it for pain relief. That being said, it is an issue whether or
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However, in the staff meeting I learned some of the nurses will put the methadone in a pill box for the patient to take on his or her own. This brings up a concern whether or not the patient can take them and use them in a negative matter. It just so happens a patient was taking the methadone out of the pill box and using them prior to the scheduled time. In the staff meeting, the practical for this was to increase the method dose. I was confused because even the primary nurse was concerned the patient was abusing the drug. Still, even when the nurse asked what she could do to prevent this, the response from the doctor was “nothing,” because we could not prove the patient was abusing the drug. This makes me wonder if we should even be using the pill box and just come every day to administer the medication. Another issue is the patient can get more of the medication if they are in need of it. Medicare will pay for additional medication while being a hospice patient. This makes it more accessible for the patient to obtain as much of the methadone as he or she wants. Another question to think about is the family members access to the medication. If the medication is in a pill box and the patient has a family member who is interested in taking methadone, then they have access to the medication also. I still think in cases like this, the nurse should come and administer the
However, in the staff meeting I learned some of the nurses will put the methadone in a pill box for the patient to take on his or her own. This brings up a concern whether or not the patient can take them and use them in a negative matter. It just so happens a patient was taking the methadone out of the pill box and using them prior to the scheduled time. In the staff meeting, the practical for this was to increase the method dose. I was confused because even the primary nurse was concerned the patient was abusing the drug. Still, even when the nurse asked what she could do to prevent this, the response from the doctor was “nothing,” because we could not prove the patient was abusing the drug. This makes me wonder if we should even be using the pill box and just come every day to administer the medication. Another issue is the patient can get more of the medication if they are in need of it. Medicare will pay for additional medication while being a hospice patient. This makes it more accessible for the patient to obtain as much of the methadone as he or she wants. Another question to think about is the family members access to the medication. If the medication is in a pill box and the patient has a family member who is interested in taking methadone, then they have access to the medication also. I still think in cases like this, the nurse should come and administer the