Is turning dying patients comfort care or not?

Specialties Hospice

Published

I work on an acute medical floor and I had a patient who was on comfort care, pretty close to death, and a two week old hip surgical site from a recent fall. There was a debate whether or not to turn the patient on the basis of pain vs risk of skin break down. Would you still turn the patient knowing this would cause more pain or leave the patient be?

Specializes in ICU.
Is it true that sometimes turning hastens death? Heard an old story about a nurse who used to turn pt's onto their left side to help them go faster... 8-0. I understand the physiology of that and so it unnerves me a little bit.

It's true........ I don't think particular side..... It's the stress on the body of the dying patient. Many a times we would reposition a very critical patient in the ICU and they would code.

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Is it true that sometimes turning hastens death? Heard an old story about a nurse who used to turn pt's onto their left side to help them go faster... 8-0. I understand the physiology of that and so it unnerves me a little bit.

I think it does.....but like one of the commenters said, If they are right at the end.

I had a patient who hung on for dear life, for nearly two weeks she was "about to go" one of the nurses told the family about the left side trick.....and they tried their best to get her to go--- turned her from left to right to left etc, etc:eek:

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I have been a Hospice Nurse for 15 years and this issue with turning a patient who is actively dying has always been very controversial among nurses, doctors and family members. I have seen doctors get mad at nurses for repositioning a pt who is actively dying.. I have seen family members do the same, as well as CNA's. I totally agree patients need skin care and gentle repositioning and it's a "pet peeve" of mine when patients go the entire shift without any repositioning. I couldn't agree more with the quote: " comfort care doesn't mean lack of care". I am so glad other nurses think like me!

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Is it true that sometimes turning hastens death? Heard an old story about a nurse who used to turn pt's onto their left side to help them go faster... 8-0. I understand the physiology of that and so it unnerves me a little bit.

Yes, a few Pts die immediately or shortly after we turn them. But many others are turned often and do not expire then.

I think it's more random than not. At least so it seems to me.

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Specializes in Gerontology, Med surg, Home Health.

Everyone is different. I, for one, do not like to be touched or fused over when I am really sick. I just want to get into a comfortable position and stay there.We turn patients to help prevent pressure ulcers...is thenpain and annoyance worth it when the patient's death is imminent? I don't think so.

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Specializes in Currently hospice.
I am slightly annoyed that someone would argue that turning a patient on comfort care should not be done. What are they thinking?

If you have ever had to lie in one position for an extended period of time, not moving or being moved, your question would be answered. You give them something for pain, if you think they are uncomfortable, you reposition them, perform a skin check, give a gentle back rub, freshen sheets/pillow case if necessary (nothing feels better than fresh clean cool after lying on them for hours) and reposition for comfort. Since comfort care patients often have frequent IV pain meds or drips, medicate again as soon as possible if you think they are uncomfortable.

Tell whomever was arguing with you that Comfort care does not mean lack of care.

I understand where you are coming from, but I have also seen turning causing extreme agony. I had a pt in the home with her three daughters taking care of her. In the last days her pain became very acute. Even with morphine, increasing her pain medication etc. when her daughters would turn her she would moan and cry out and sob, so the daughters would not do it. I did everything I could, increased the pain med, really talked with the family about the importance, etc. But in the end, the truth was, she was very close and it caused everyone, including the pt much more agony than it was worth.......

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I understand where you are coming from, but I have also seen turning causing extreme agony. I had a pt in the home with her three daughters taking care of her. In the last days her pain became very acute. Even with morphine, increasing her pain medication etc. when her daughters would turn her she would moan and cry out and sob, so the daughters would not do it. I did everything I could, increased the pain med, really talked with the family about the importance, etc. But in the end, the truth was, she was very close and it caused everyone, including the pt much more agony than it was worth.......

Everyone needs to be judgeed individually......I have a neuromuscalr disorder and I know how stiff I can get but I feel better after I make myself move. Of course if it is agony....the patients comfort is paramount.

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What do you mean "emissions"

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