A hospice nurse asked if we, the medical caregivers, should be taking scheduled or frequent blood pressures when caring for someone whose end of life is approaching. That question made me think about how tuned into medical procedures we healthcare workers are. Blood pressures, lab work, pulse, respirations, and temperature — all routinely taken and recorded.
My answer is NO we do not need to take a blood pressure (or any of the other routine medical procedures) every visit, and particularly when the active, imminent dying process has begun.
What are we going to do with that knowledge? What can we do? What will it tell us that we don’t already know? This person is actively dying. Other more important signs tell us that death is approaching: congestion, changes in breathing, awareness level, a weak pulse, or mottling – a discoloration of hands and feet. Those signs tell us what we need to know about the patient’s condition. Who needs the blood pressure?
As death approaches, taking a blood pressure is one more unnecessary intrusion for the patient and for the family. Will what you learn affect anything? Are you going to do anything about it? NO. Will taking a blood pressure bring comfort and relieve fear? NO.
With today’s emphasis on time management and visit length, let’s use the time and contact with the patient and caregivers to address everyone’s fear, to give them guidance on how to support their person. Our work is beyond medical procedures. Our work is to comfort. It is reassurance that nothing bad is happening.
Words, time, support, and reassurance are the medicines and procedures that are appropriate as death approaches.
Something more about… Stop Chasing Vitals. Start Comforting.
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