vital signs

Specialties Hospice

Published

When an on call nurse goes to a home, is it essential that she get all the vital signs each visit, even if they do not apply to the present situation? Is this something that varies state to state?

Specializes in Hospice, OR, Home Health, Orthopedics.
Very interesting to see the various thought processes on this issue. It is not a requirement by JCAHO or Medicare to do VS. This would be more of what your agencies P & P manual had in it. My own thought process is that a lot of the time this will increase a family and patient's anxiety because then they are concerned with it being to high or to low. At the same time depending on the patient's phsyical status you can almost bet it will be pretty elevated (increased pain or discomfort or anxiety) or pretty low (patient actively dying) so it will almost always vary. If it is elevated or low the patient or family will want to know what you are going to do to "fix" it. I do agree there are many times by doing these assessments it does make both family and patient feel that they are not dead yet and that you are truly taking care of them. So I guess my feeling is it based on their current "needs" and is uniquely individualized on each visit as with every other aspect of Hospice care. Andyg

We always take a full set of vitals on each visit and do so because we feel it is necessary to a full nursing assessment. I personally feel I can advise the family more accurately as to how much "time" they have and etc because for me, they give the nurse the whole perspective along with other indicative factors. We all know the signs of approaching death, and an actively dying patient, this is not the place to spell those out. But you know, they can have a lot of those signs with good Vitals. When the vitals change, you can advise the family (always with the disclaimer that a higher power is always in charge) what time is left. It's just always been a good tool for us. And I haven't had a family yet that didn't want to KNOW what they were. Do your families ever ask? :nurse:

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I've only had one family member ask me if I was going to check vitals (when I had not.)

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Specializes in Med-Surg, Rehab, MRDD, Home Health.
We always take a full set of vitals on each visit and do so because we feel it is necessary to a full nursing assessment. I personally feel I can advise the family more accurately as to how much "time" they have and etc because for me, they give the nurse the whole perspective along with other indicative factors. We all know the signs of approaching death, and an actively dying patient, this is not the place to spell those out. But you know, they can have a lot of those signs with good Vitals. When the vitals change, you can advise the family (always with the disclaimer that a higher power is always in charge) what time is left. It's just always been a good tool for us. And I haven't had a family yet that didn't want to KNOW what they were. Do your families ever ask? :nurse:

Yes, I have many families that ask about vitals if I do not tell them first. This

is a good discussion here, seems to be split 50/50, it's always helpful to know how others handle their roles.

I would just like to add a little more to the discussion: I don't get fixated on the vitals, and I try not to ever use vitals in a negative way when dealing with families. I use vitals as a diagnostic tool and as a psyhcological tool

to help family members cope. If I perceive that taking vitals would be more of

a stressor than a coping mechanism, I will defer. I handle each patient and

each family member/caregiver different, and pray to God to give me the wisdom to make the right decisions.

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