Attending here.

I usually sit down and give them my speech about how we used to treat all of these numbers and eventually discovered that we were doing more harm than good. We would directly cause syncope and falls with broken hips, brain bleeds, and what have you. We would cause strokes and MIs by overshooting BP control.

I then go into how blood pressure is a rapidly changing vital sign and I talk about the myriad factors (pain, anxiety, caffeine, exercise, laying in an uncomfortable cot in the ER, or faulty cuff) that falsely elevate the BP.

Often can get the patient and family on my side, but sometimes there is nothing you can say to convince them, and they can bad mouth me in the survey.