Yes, some patients are aware that they are "breathless", but then their are others who do not realize what the changes are they are experiencing. I have experienced seeing this since I have been in hospice. Some nurses may have experienced patients who have delirium or who may ask, what is happening to me. When this occurs, the nurse must make the decision to provide comfort to the patient at his or her dying time. My rationale is to have measureable documentation. We know now that we must document throughly everything we do in hospice, and that includes determining by measureable means the reason we did what we have done. In our system here, surveyors will tear a chart apart looking for this documentation. Experience has taught me to document, document, document. Hope this gives light to you on why I have rationaled using O2 on a person who knows he is breathless.
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