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mark occomore
Joined: 07 Dec 2006
Posts: 9955
Location: UK
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 Posted: Sat Oct 27, 2007 11:47 am Post subject: Should Nurses resuscitate patients? |
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Experienced nurses should have the authority to decide if patients should be resuscitated, according to new guidelines to health professionals
http://news.bbc.co.uk/1/hi/uk/7065010.stm
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They are proffessional medical staff so maybe they should have some powers? |
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gfloyd
Joined: 07 Dec 2006
Posts: 4861
Location: Here, There, Everywhere.
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| Posted: Sat Oct 27, 2007 11:48 am Post subject: Re: Should Nurses resuscitate patients? |
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| mark occomore wrote: |
They are proffessional medical staff so maybe they should have some powers? |
But should they have the power to decide who lives & who dies?
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nod
Joined: 24 Dec 2006
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| Posted: Sat Oct 27, 2007 3:27 pm Post subject: |
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It will be the experienced cleaners next deciding if you live or die...
...but hang on they don't seem to have any of those  |
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firewirefred
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| Posted: Sat Oct 27, 2007 3:37 pm Post subject: Re: Should Nurses resuscitate patients? |
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| mark occomore wrote: | Experienced nurses should have the authority to decide if patients should be resuscitated, according to new guidelines to health professionals
http://news.bbc.co.uk/1/hi/uk/7065010.stm
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They are proffessional medical staff so maybe they should have some powers? |
A Radiologist is a profffessional member of the medical staff but does that mean they can execute "powers" in the same manner? |
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SantaFefan
Joined: 07 Dec 2006
Posts: 11258
Location: top of the cliffs in Norfolk
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| Posted: Sat Oct 27, 2007 3:47 pm Post subject: |
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Not a hospital situation but, most of our elderly residents have a note on their file as to whether they want to be resuscitated or not. Even this isn't completely satisfactory as the decision may needed before we can check the details.
We even thought of labelling the backface of wardrobe doors as DNR.
My mother died a couple of weeks ago after a short but terminal illness and I witnessed the paramedics trying their best to get her breathing again with some success only to be taken to hospital to pass away 20 minutes later.
Personally, I don't think it should have happened that way. I think they should have helped her to die but that's another question...
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gfloyd
Joined: 07 Dec 2006
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| Posted: Sat Oct 27, 2007 3:49 pm Post subject: |
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Well everybody should get a go in my opinion. Nurses on Mondays & Fridays, cleaners on Tuesdays, hospital radio DJ's at the weekend.
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mark occomore
Joined: 07 Dec 2006
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Location: UK
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| Posted: Sat Oct 27, 2007 3:56 pm Post subject: |
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| gfloyd wrote: | | Well everybody should get a go in my opinion. hospital radio DJ's at the weekend. |
Only on request shows.  |
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nod
Joined: 24 Dec 2006
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| Posted: Sat Oct 27, 2007 3:58 pm Post subject: |
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I liked this bit
"The Resuscitation Council said resuscitation may only work in 5% of cases, and that the guidelines aim to avoid "undignified and unnecessary" resuscitation of patients who would not benefit from it. "
So staying alive could be 'undignifed and unnecessary' ? 
..well sorry about that |
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gfloyd
Joined: 07 Dec 2006
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| Posted: Sat Oct 27, 2007 4:15 pm Post subject: |
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| nod wrote: | So staying alive could be 'undignifed and unecessary' ?
..well sorry about that |
If they let the hospital accountants have a go at deciding, that off switch is going to worn out pretty quickly.
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SantaFefan
Joined: 07 Dec 2006
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Location: top of the cliffs in Norfolk
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| Posted: Sat Oct 27, 2007 4:26 pm Post subject: |
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| nod wrote: | I liked this bit
"The Resuscitation Council said resuscitation may only work in 5% of cases, and that the guidelines aim to avoid "undignified and unnecessary" resuscitation of patients who would not benefit from it. "
So staying alive could be 'undignifed and unnecessary' ?
..well sorry about that |
I'm really surprised you think that. You must accept that sometimes it just isn't worth/practical/sensible/dignified/ justified to revive a patient who's dying anyway?
I recently seen a man go from a strapping fellow to a virtual skeleton in weeks because of cancer. I had to lift him into bed on his last day and no doubt they could have kept him alive for another day or so but he didn't want it, neither did his family.
He died peacefully in his own bed with people who loved him by his side. Surely this is better than anonymously in a hospital bed?
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gfloyd
Joined: 07 Dec 2006
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| Posted: Sat Oct 27, 2007 4:29 pm Post subject: |
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| SantaFefan wrote: | | nod wrote: | I liked this bit
"The Resuscitation Council said resuscitation may only work in 5% of cases, and that the guidelines aim to avoid "undignified and unnecessary" resuscitation of patients who would not benefit from it. "
So staying alive could be 'undignifed and unnecessary' ?
..well sorry about that |
I'm really surprised you think that. You must accept that sometimes it just isn't worth/practical/sensible/dignified/ justified to revive a patient who's dying anyway?
I recently seen a man go from a strapping fellow to a virtual skeleton in weeks because of cancer. I had to lift him into bed on his last day and no doubt they could have kept him alive for another day or so but he didn't want it, neither did his family.
He died peacefully in his own bed with people who loved him by his side. Surely this is better than anonymously in a hospital bed? |
I agree with you. But the decision should not be taken lightly. Getting back to the opening question: Who should decide? This surely must be one of the most important decisions a doctor can make. To delegate it to nurses seems wrong to me.
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Rob
Joined: 27 Feb 2007
Posts: 163
Location: Leicester
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| Posted: Sun Oct 28, 2007 6:12 pm Post subject: |
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| gfloyd wrote: | | SantaFefan wrote: | | nod wrote: | I liked this bit
"The Resuscitation Council said resuscitation may only work in 5% of cases, and that the guidelines aim to avoid "undignified and unnecessary" resuscitation of patients who would not benefit from it. "
So staying alive could be 'undignifed and unnecessary' ?
..well sorry about that |
I'm really surprised you think that. You must accept that sometimes it just isn't worth/practical/sensible/dignified/ justified to revive a patient who's dying anyway?
I recently seen a man go from a strapping fellow to a virtual skeleton in weeks because of cancer. I had to lift him into bed on his last day and no doubt they could have kept him alive for another day or so but he didn't want it, neither did his family.
He died peacefully in his own bed with people who loved him by his side. Surely this is better than anonymously in a hospital bed? |
I agree with you. But the decision should not be taken lightly. Getting back to the opening question: Who should decide? This surely must be one of the most important decisions a doctor can make. To delegate it to nurses seems wrong to me. |
Often it's the nurses who know the patient best. That means that the decision is anything but anonymous.
Besides, the proposal isn't for any nurse to take the decision - just the most senior. From what's been said on the telly, not all of them. It would have to be part of the job description, basically, so only those deemed competant would be allowed to make the choice. Some of the senior nurses are better qualified than some of the doctors, after all.
To my mind, the person taking the decision should:
a) be familiar with the individual, if that's possible (you can't wait for 20 minutes for someone who knows the individual to be found),
b) be experienced in resuscitation, so they have some idea of whether it's likely to be successful.
c) take into account the general health of the individual. The decision for an injured young, fit person might be different than for a person in the last stages of a terminal disease.
d) care.
Provided these criteria are met, I'm not bothered whether their job description is labelled "doctor" or "nurse".
Rob. |
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SantaFefan
Joined: 07 Dec 2006
Posts: 11258
Location: top of the cliffs in Norfolk
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| Posted: Sun Oct 28, 2007 9:47 pm Post subject: |
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| Rob wrote: | Often it's the nurses who know the patient best. That means that the decision is anything but anonymous.
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Of course I agree when the patient has been hospitalised for a time.
I was thinking in terms of an emergency admission.
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Johnnie Walker read out my message on Pirate Radio! 13/8/07
I have heard how radio should be. |
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iwarburton
Joined: 08 Dec 2006
Posts: 2133
Location: Northumberland
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| Posted: Sun Oct 28, 2007 9:52 pm Post subject: |
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I'm undecided on this one and would be interested to know what nurses themselves think.
Ian. |
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Barkingbiker
Joined: 11 Dec 2006
Posts: 2313
Location: Lincolnshire
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| Posted: Sun Oct 28, 2007 11:23 pm Post subject: |
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We have "nurse practitioners" in our local GP surgery and in my experience they give an excellent service and diagnosis, which, IMHO, has been equal or better than seeing a doctor. These nurses, as I understand the proposals, would only be nurses that have the relevant experience and aptitude to make these decisions. I feel sure that under the criteria being stated these nurses will be able to make a decision without having to wait for a doctor, which could, and should, lower the odds of the patient sustaining any permanent damage when resucsitation is carried out.
BB 
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iwarburton
Joined: 08 Dec 2006
Posts: 2133
Location: Northumberland
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| Posted: Mon Oct 29, 2007 5:07 pm Post subject: |
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Was reminded today of a slight complication. In hospital a consultant (senior medic) is ultimately responsible for the patient. How does this square with delegation of responsibility to the nurse?
Ian. |
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gfloyd
Joined: 07 Dec 2006
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| Posted: Mon Oct 29, 2007 7:48 pm Post subject: |
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Why are doctors paid £100k + if they can delegate the life & death decisions?
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Barkingbiker
Joined: 11 Dec 2006
Posts: 2313
Location: Lincolnshire
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| Posted: Mon Oct 29, 2007 8:00 pm Post subject: |
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| gfloyd wrote: | | Why are doctors paid £100k + if they can delegate the life & death decisions? |
I don't think it's a case of direct delegation, my perception is that the decision will be made by who ever is there, the senior doctor or the senior nurse, with the authority. Time being of the essense to alleviate the risk of permanent damage to the patient.
BB
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