Hospice patient and vitals

[Goofaroo]

Yesterday working in a nursing home a family member approached me and rudely said why has a set of vitals not been take on her family member who happens to be actively dying and on hospice care. She said this should be a priority patient and griped at me up and down about it. I didn't know what to say accept that I had not gotten around to it yet. There was no indication that I needed to take vitals, other family was at the bedside since I arrived on the shift. I entered the room 2 times to check on everything and the patient had no signs of distress just lying there quietly. Am I wrong for not taking vitals on this patient?

[VivaLasViejas, ASN, RN]

my husband was recently inpatient at a large teaching hospital.he had terminal cancer .he made himself DNR/DNI/CMO. They started a dilaudid drip .I and my family were with him for hours.they offered us chairs blankets food coffee.The nurses would come in ask me if I wanted vitals turning etc to be done.If we thought he was uncomfortable they went up on drip and gave prns.no vitals needed.He passed away may 14th after a 2 1/2 year battle radiation and chemo .he had 41 treatments .

I'm so sorry for your loss. My husband died in hospice care of pancreatic cancer last July, so I feel for you. As a nurse I didn't insist on vitals either; what good would it have done? All I wanted was for him to have good pain relief and die peacefully, which I think is what most families want for their loved ones. Non-medical people usually don't understand the dying process, and some want vitals done so they know what's going on with the patient. I get that...still, it's so unnecessary and can cause discomfort for the dying person. I wish doctors would do a better job of educating families about death; it would make it easier for us to do our jobs.

[Morainey, BSN, RN]

I probably wouldn't have told them that you hadn't gotten around to it yet. I think there are other really good suggestions on this thread for responses - such as explaining that a thermometer or BP cuff can be invasive or painful, or that frequent VS monitoring isn't indicated.

Family members sometimes need to make their voices heard as part of their coping process. It's difficult to watch a loved one when you know the inevitable is coming, and some people handle it differently than others. Whenever my stepfather was in the hospital, his daughter would make the biggest stink - harassing the nurses and second guessing their every move. And she's a nurse herself!! I'll never understand some people.

[nuangel1, BSN, RN]

thankyou very much .it has been very tough year.

[nuangel1, BSN, RN]

Thank you Viva ,I am very sorry for your loss also.i have been a RN for 30 years my husband was RN for 36 years.He had back pain in winter 2014-2015.By Feb 2015 he could not work had MRI which showed he had abnormal bone marrow ie. Cancer.We were surprised at diagnosis stage 4 Mets to his spine.He had 3 compression fractures .Primary was cecal/colon.started rad and chemo by July 2015 He went back to work 3 days a week 8 hrs in the ED he had worked in for 35 years.Did well till 1/11/17.surgery sepsis pneumonia uti and dvt .9 week admission.I brought him home for 3 weeks.Then readmitted sepsis again.Died from subdural bleed most likely from blood thinner for DVT.All I wanted was pain relief and a peaceful passing .No more suffering.He had fought so hard .We had great nurses so caring and supportive.

[VivaLasViejas, ASN, RN]

(((((HUGS)))))