Quote from Katie5
What exactly constitutes this?And since you need a physician's order for oxygen, should this be considered a "within nurses' discretion for comfort measures. And why not just the physician or hospital write what the comfort measures should consist of or not.
Comfort measures are generally outlined in standing order sets within the hospital. In the absence of standing orders signed by the MD, specific orders should be written.
Comfort orders generally include things like, no routine lab draws, discontinuation of routine VS checks especially during the night, diet as tolerated, O2 for comfort, and liberalized medication plans for pain, anxiety, nausea, etc. Foley catheters are often ordered for patient dignity and comfort and are provided only if the patient or the family agree. Initiation of the specific elements of the comfort orders is based upon the assessment of the RN and does not require the notification of the MD when they are used. Every attempt is made to remove all noxious interactions which are not absolutely required for the well being of the patient. The focus of the care becomes comfort rather than diagnostic or curative.
Comfort care orders may include use of some medications in a fashion which some nurses may not be familiar or comfortable. For instance, use of morphine for dyspnea may be new to some med surg nurses or use of haloperidol for nausea may be unfamiliar.
Frequently medications which are not critical to the immediate comfort of the patient are discontinued.
In the hospital setting family visitation hours are often liberalized to allow family nearly unlimited access to their loved one in the final hours/days.