If pain from end-of-life symptoms is not adequately controlled and the family asks for more morphine, what is the most appropriate information the practical nurse should communicate?

• A. I understand your distress. Let's discuss this.
• B. I will arrange a meeting with the pain team for us to find a solution.
• C. I will speak with the physician to ask him what to do.
• D. I am not allowed, as a registered practical nurse, to administer increased doses of medication that will cause him to die more quickly.

Answer: (B)

The main skill here is coordinating care to control pain effectively in end-of-life situations while keeping the family informed. The best move is to arrange a meeting with the pain team so they can review the current pain regimen, assess the patient’s pain level, and develop an agreed plan to optimize relief. This demonstrates proactive, interprofessional collaboration focused on the patient’s comfort and safety, and it helps ensure any dose adjustments are properly evaluated and ordered.

Simply showing empathy (expressing understanding of distress) is important, but it doesn’t establish a plan to improve pain. Asking to involve a physician is reasonable, but a team meeting with the pain specialists is the most comprehensive way to address complex symptom management. Claiming you cannot adjust doses is inaccurate for palliative care, where analgesia is titrated within the patient’s orders and with team guidance; the goal is to relieve suffering, not to hasten death.