Checking visitor's vitals

[AJPV]

What would you do in this scenario? A nurse is in a hospital room doing vital signs. The mother of the patient is visiting along with a couple other family members. The mother of the patient comments that she (the mother) isn't feeling great (feeling weak & a little light-headed) and asks the nurse if she can take her BP. She comments that she takes a BP medication. The nurse checks her vitals and everything is A-okay. The nurse tells her the vitals but adds that if she is still not feeling right she should go get checked out by an MD right away. The nurse mentions that the mother could go to the ER, but the mother and family downplay the need for this. The nurse doesn't push the issue further.

Questions... Did the nurse put herself or her hospital at legal risk by her actions? Did the fact that she did not institute an official healthcare agency response (ie, insisting that she go to the ER now, placing her in a wheelchair and escorting her to the ER, or getting the charge nurse or an MD who happens to be on the floor) fall short of what she should have done? Should the nurse have completed an incident report?

[nightengalegoddess]

This woman probably never feels ok when someone else is suffering. Maybe that is why the family downplayed it? She's not a patient, hope you documented that you took vitals which were ok....documented that the offer was made, documented that the offer was turned down verbally.....I think you are ok.

[itsmejuli]

Is this a homework question?

[SkylerW]

Your supposed to take vitals on a non PT due to liability issues PLUS an employee is never

supposed to escort a non PT, but a volunteer can.

[AJPV]

Thanks for the feedback - those are great tips! It's not a homework question. Just personal musings based on observations. I like to think through how I would want to respond...

[Blackcat99]

When I worked at LTC many years ago we were told not to check visitor's vital signs. Apparently one of the nurses did check a visitor's vs and then that same visitor would ask to have his BP checked every time he visited.

Another visitor saw it and then that new visitor asked the nurse if she could check her BP too. Kind of like you checked his blood pressure so you should check my BP too.

[nerdtonurse?, BSN, RN]

I had a family member visiting a post MI patient, and I walked into the room, started my "Hi, I'm Nerd and I'll be your --- sir, do you feel okay?" Pt's son in law was about 300 pounds, smelled like tobacco, sweaty, out of breath, gray. He was saying he was going to drive back home and lay down -- wife asked me to take his BP, and I did, which was thru the roof. We got him into a wheelchair and to the ER, where he was found to be in the middle of a huge MI, and almost coded. Had he got in the car and tried to drive home (about 60 miles), I doubt he would have made it, and might have killed someone on the road with him. I got yelled at for doing vitals, "starting the nurse patient relationship" what if he'd left anyway, they could have sued, etc. I kept saying, "but the guy was having an MI" -- didn't matter. My charge nurse yelled at me, told me if something bad had happened, neither mine or the hospital's insurance would have covered me.

Now, if I saw that going on again, I'd tell the patient, "Okay, we're taking you to the ER to get checked out, get in the wheelchair right NOW."

BTW, the next night patient I was originally going in to see again, the wife (who was the patient's daughter) was there and she hugged me and said, "thanks for saving my husband's life."

[AJPV]

nerdtonurse: How crazy that you got yelled at! I think some of the self-protective behavior that hospitals engage in actually increases the liklihood that they may be sued. There are lots of studies showing that the liklihood of a nurse or doc being sued falls dramatically when the patient/family believes the professional really cared and that he or she did all that they could. This even holds true when the patient/family are aware that real medical/nursing mistakes were made!

[MrChicagoRN, RN]

Your supposed to take vitals on a non PT due to liability issues PLUS an employee is never

supposed to escort a non PT, but a volunteer can.

Each institution decides what the staff can & can't do. That has't been the policy anywhere I've worked.

[ChristineN, BSN, RN]

The policy at places may say to advise them to go to the ER and not begin treatment on the floor, but sometimes you've gotta do what you've gotta do. When I was a brand new nurse I ended up calling a code on a visitor as I walked in and found the visitor having a grand mal seizure. In that situation, you aren't going to move the pt, you've got to start treatment ASAP.

[Tait, MSN, RN]

I was always adamant that a patient who didn't feel well should go to the ER. I remember a young guy who went home to do something and came back and showed me his hands. He said "I slammed them both in a window, could I get one of those percocets my girlfriend has been getting?" I politely said no and told him I really thought he should head to the ER for an xray. Suddenly his hands didn't hurt so bad.

My story isn't about vitals, but it all sort of applies in my book. If you aren't my patient than you need to go to the ER and get admitted, then I will be more than happy to take your vitals, as your nurse.

[MrChicagoRN, RN]

What would you do in this scenario? A nurse is in a hospital room doing vital signs. The mother of the patient is visiting along with a couple other family members. The mother of the patient comments that she (the mother) isn't feeling great (feeling weak & a little light-headed) and asks the nurse if she can take her BP. She comments that she takes a BP medication. The nurse checks her vitals and everything is A-okay. The nurse tells her the vitals but adds that if she is still not feeling right she should go get checked out by an MD right away. The nurse mentions that the mother could go to the ER, but the mother and family downplay the need for this. The nurse doesn't push the issue further.

Questions... Did the nurse put herself or her hospital at legal risk by her actions? Did the fact that she did not institute an official healthcare agency response (ie, insisting that she go to the ER now, placing her in a wheelchair and escorting her to the ER, or getting the charge nurse or an MD who happens to be on the floor) fall short of what she should have done? Should the nurse have completed an incident report?

Many visitors are old & frail, and under emotional stress. I"ll check their BP, give them some juice and crackers if they're feeling a little weak (then direct them to the cafeteria), whatever.

Possible outcomes:

You check their vitals, WNL, write it down for them & say, "if you're still not feeling well, you may want to f/u with your MD. Don't discuss meds, diet, or anything else. They're fine, they're happy that the staff cares about someone even if they're not being paid to do so.

You check, BP elevated; recommend f/u with MD or ER, depending on severity. After that it's up to them, but at least they are making an informed decision. They say thank you, and make their decision

You don't check...patient and family decide the staff here are caring & unfriendly. Chilling effect on the way they interact with you during their stay. They say so in their surveys, to their friends and neighbors, and maybe on their FB page.

You don't check...30 minutes later family member collapses on the floor, maybe needs CPR. Deep down you wonder if this could have been avoided if that dangerous BP had been noted.

It's much simpler to just check the BP, provide the data and direction, and move on.