05 August 2014

Nurchat discussion - The right to not resuscitate

Can there ever be a more emotional time in life than death?  Following a recent landmark ruling against Cambridge University Hospitals NHS Foundation, Nurchat are meeting tonight at 8pm on Twitter via #nurchat  to discuss end of life intervention and the issue of DNAR (Do Not Attempt Resuscitation) orders.  Nurchat is an online discussion group for healthcare professionals, dedicated to raising and deliberating the most important issues affecting the sector.

The case against Cambridge University Hospitals NHS Foundation was prompted by the death of Janet Tracey, a cancer patient, admitted to hospital following a car crash.  Mrs Tracey’s family asked for an initial DNAR order to be removed from her file, however she died days later following the implementation of a second DNAR to her records.  Janet’s husband is quoted as saying “At one point she told me they were trying to get rid of her and I told her not to be silly, which proved to be a mistake. She was panicked. They were questioning her all the time about a DNACPR (do not attempt cardio-pulmonary resuscitation order).”

Cardiopulmonary resuscitation, attempting to restore breathing or blood flow to critically-ill patients, is often a violent process with rib fractures and brain injury significant risks. But although the law makes clear the final word on such issues lies with medical staff, there has been an apparent lack of clarity over just how far they have to go in consulting a patient with mental capacity or their families about their wishes. 

Are you a healthcare professional, patient or relative? Are you involved in the DNAR process?  Do you feel the best interests of a patient are represented by medical staff when a DNAR order is implemented? Do you feel that the medical teams should ever give up on a patient and if so do they have the right to?  Do you think the DNAR process is too complex and too distressing for patients and relatives? Should the responsibility of facilitating a DNAR conversation fall to nursing staff or is it beyond their remit?