“Do Not Resuscitate”—Let’s Talk about CPR

Originally posted by boymonkey74
reply to post by soulwaxer

 

We had a test case in which a man who couldn't move at all wanted to die and unfortunatly he lost the case so people still have to suffer here in the UK.
Good to know other countrys are getting it right though.

I know about that case. The law here states that you have to have an incurable physical or mental condition, and you have to be suffering unbearably. This suffering is judged by a physical doctor, in case the condition is physical, and a second opinion is needed. When the case condition is mental, you also need a 3rd opinion from a psychiatrist. The person you are talking about is mostly a mental suffering situation, but he would have gotten his wish here.

The difficult cases are young people with a mental condition such as a bad case of bipolar, for example. Imagine someone asking for euthanasia when just a week earlier you saw them happy and functioning well. I'm associated with a team of experts that guides people in these situations. It can get very complicating, to say the least.

reply to post by soulwaxer


Oh I agree you have to have many people agreeing and it should never be a decision taken lightly.

Originally posted by boymonkey74
reply to post by soulwaxer

 

Oh I agree you have to have many people agreeing and it should never be a decision taken lightly.

Indeed. And to be honest, I would personally not join a team involved in making these decisions. I have no problem with a patient making these decisions for themselves, but I just don't feel "worthy" of this power over someone else. On the other hand, I do respect those who are capable of this, as long as their intentions are pure.

I am a retired FDNY Paramedic, I worked on an Ambulance in Manhattan North area and Jamaica Queens for 20 years. I have had numerous jobs where a family member handed me a Out of Hospital DNR while crying and asking me to save the patient. At that point the DNR is null and void and unless there are obvious signs of death (Dependant Lividity, rigor mortis or injuries incompatible with life) CPR begins and continues all the way to the Hospital. Also even if the patient is cold and stiff but the family is asking you to do something, most EMS in NYC that I know would start CPR for the family.

Personally my attitude in regards to the out of hospital DNRs is that I would rather get in trouble for ignoring a DNR than ignoring my gut feeling.

I've got 'end game' emphysema. I haven't got to the stage of snuffing it, but would readily sign a form NOT to resuscitate. I'm hoping to get sleep apnea or just die during sleep, but I do sleep very lightly.

The question of a DNR is hard.it still comes down to the question of quality and quantity of life,and that is what most hospitals and nursing homes go by,is what kind of quality does the patient have in life,do you really want to bring someone back that has congestive heart failure are someone who has more of a chance to survive and live a more quantity of life.Also you can do more damage to a elderly person by performing CPR their bones are more brittle than others and in some cases their ribs are sternum can sustain broken bones. i know it is hard for people to let their love ones go,but sometimes it is best for their love one..worked in nursing home for 25 years and sometimes a family member would want their love one to be resuscitated and i wonder why are you wanting your family member that has a breathing tube cannot get out of bed anymore and a feeding to tube be brought back to life to suffer more and maybe in worse shape than before

Originally posted by boymonkey74
What is stopping our governments bringing in laws that would help people who want to be assisted in their passing?

I think they are scared. It's new ... it's bold ... it's what is needed (ALL OVER THE WORLD) .. but the people who are elected are too afraid of not winning their next election if they go too far away from how things are now. New things scare people. And a politician knows he/she can't scare people and still win the next election.

Originally posted by woodwardjnr
I was just about to post the soylent green death scene clip.

That's EXACTLY what I'd like to see. All over the world. For ANY adult who desires it.
There shouldn't be requirements of having a deadly disease, or that you are six months
from death from cancer, or anything like that. I know a lot of people who are suffering
but who are not considered to be 'terminal'. And I know a lot of people who have
progressive diseases and are afraid, not of death, but of having to be here with the
suffering and pain.

I'm not ready to check out yet, but I really wish that the places they had in Soylent Green
were available to any adult in the world for when they thought they wished to use them.

ETA - www.youtube.com... the scene from Soylent Green.

Originally posted by FlyersFan

Originally posted by woodwardjnr
I was just about to post the soylent green death scene clip.

That's EXACTLY what I'd like to see. All over the world. For ANY adult who desires it.
There shouldn't be requirements of having a deadly disease, or that you are six months
from death from cancer, or anything like that. I know a lot of people who are suffering
but who are not considered to be 'terminal'. And I know a lot of people who have
progressive diseases and are afraid, not of death, but of having to be here with the
suffering and pain.

I'm not ready to check out yet, but I really wish that the places they had in Soylent Green
were available to any adult in the world for when they thought they wished to use them.

ETA - www.youtube.com... the scene from Soylent Green.

edit on 3/7/2013 by FlyersFan because: (no reason given)

People who WANT to die already have options.Its called suicide. Would you really want the Government (of any country) to be involved with hastening people to the grave? Everyone knows that the gov will abuse anything placed in front of them. How long would it be before they starting murdering people just for disagreeing with them.

Originally posted by ohioriver

Originally posted by zbeliever
I see a lot of justifying on here. If someone deliberately does something they know will cause your death, it is murder. Plain and simple. Its one thing to have a DNR, but to decide who gets to be saved based on ones own personal interpretation of what someone else's life is worth is wrong.Life is precious, even if its only for 2 weeks. I am so sorry there are so many people on here whose moral centers are so off-kilter. It is not OK to treat the ill and elderly that way.

]

I totally agree with you. Patients should be at the centre of their care - not passive onlookers taking orders from various health professionals.

Care should have patients dead centre and drs, nurses, physios etc consulting with the person so that the care is planned and delivered in a manner that is compassionate, intelligent and skilled.

Originally posted by OtherSideOfTheCoin
reply to post by beckybecky

 

There is no such thing as a pathway to death, I bet you have never ever actually seen a LCP let alone used one

I don’t get any bonus if a patient dies

I don’t have time to sit around the nurses’ station chatting

I don’t think you will be saying we should have a 50% pay cut when you end up on a ward

And I already do more than enough paper work.

You clearly know nothing about nursing please stop with your ignorance.

edit on 6-3-2013 by OtherSideOfTheCoin because: (no reason given)

well you must be the exception.

i speak from experience and stark reality.

my mum suffered a stroke.the auxiliaries were trying to do all the hard work while the nurse princess were gathered around the nurses station chatting about who was shagging who.they had airs and graces as if work was beneath them.they would not even feed my mum as she was incapable of feeding herself.i am so angry.so now you understand why i hate and detest nurses.

i mean they get £30000 a year and are their just to have a good time.

i would not want to be on a ward with the very poor standard or nurses and doctors.it's your own fault for the paperwork for not resisting it.

the hospital gets extra grant money for every patient put on the liverpool death pathway.it was in the news.check it yourself.

reply to post by OtherSideOfTheCoin


All rhetoric, all pros and cons for and against the viability of CPR as it pertains to this case, I am sure this assisted living facility has covered all their legal/liability bases, particularly since the daughter has in effect endorsed the inaction of the the facility and nurse.

However, if I had a parent in this Assisted Living Facility, they would be being moved elsewhere immediately and I have zero doubt that is happening even now by the children of many who have parents in this facility. The American Way to show disapproval is to not, not support and reject those we do not approve of and in my book, I do not approve of the Policy of this Facility and the nurse can be glad I am not her potentially next employer, because I would not.

Another UK Nurse here. I work in a prison that is one of the few that has an end-of-life suite. We use DNAR orders and also use the LCP. It is all above board, legal and done with compassion and the patient in mind. ALL deaths in a prison are considered a Death in Custody, this includes DNARs and LCPs and are rigorously investigated, not only by the Police, but by the Coroner and also Prison Ombudsmen. Each one that I have had an involvement in, I have been part of the investigation process. DO NOT believe what you read in the media, they have an agenda.

Originally posted by boymonkey74
reply to post by mysterioustranger

 

My last resident who died did that, his mobility went down hill very quickly and when I went to check on him at the start of my shift he was delirious in his chair and his breathing and heart beat was erratic so we got an ambulance and I went to hospital with him.
When in hospital he fought with the nurses trying to put a fluid drip in him saying "No No my wife wants me to go with her" pointing at one corner of the room then he just closed his eyes and died.
I just hope it wasn't a delusion and he had his wife waiting for him somewhere.

Thank you for posting your experience. I too have been in the room as someone passed and they had pointed and talked about their family members waiting for them, there in the room.

My Pop, before he passed a few months ago would talk about how his dad, two of his brothers and one of his sons would come talk to him in the mornings. BTW, he did not know that one of the brothers, nor the son were dead. We never told him, choosing to spare him the pain. He also suffered from pretty severe dementia and did not or could not put together that he was talking to the dead (and in his mind) the living at the same time, "in spirit".

I went to wake him one morning and found him slumped on the floor with no life signs. I did not start CPR even though it was evident that his event was probably only a minute or two earlier. He had a slight smile on his face. I called 911 and then his dog and I waited with him until they came. They did not attempt resuscitation.

He was 87, a brittle diabetic with lung disease, congestive heart failure, kidney failure/dialysis dependent, and moderate, sometimes severe dementia. His quality of life to that point was not terrible, difficult yes, but not bad, considering. I cared for him the last eight years of his life and worked hard to make his life as full and comfortable as I could. But I would never have allowed extraordinary life saving efforts. I couldn't have handled having to watch him suffer in hospital, with strangers, and unable to understand what was happening to him. There was no coming back for him. It would have been inhumane to force life on someone who was ready to go and had people he loved waiting for him to join them.

Originally posted by Wotan
Another UK Nurse here. I work in a prison that is one of the few that has an end-of-life suite. We use DNAR orders and also use the LCP. It is all above board, legal and done with compassion and the patient in mind. ALL deaths in a prison are considered a Death in Custody, this includes DNARs and LCPs and are rigorously investigated, not only by the Police, but by the Coroner and also Prison Ombudsmen. Each one that I have had an involvement in, I have been part of the investigation process. DO NOT believe what you read in the media, they have an agenda.

Being someone who is and has been going through the process of having an "Aortic Value Replaced" and other steps to resolve problems with my heart, I have been very fortunate to have a heart specialist who has made sure to clue nursing staff in on my utter lack of tolerance for nurses that do other than they are told. Yes, it is true, my first wife was an Intensive Care Nurse who became the head nurse of the Burn Unit at a very large hospital in Houston and having put her through college, I was very proud of her successes but there is something about dealing with hurt and dying people that changes people, particularly nurses. Point in fact, I do not like Nurses. am drawn t being hard on nurses and am drawn to putting them in their place like a cowboy on a green-broke pony. I feel sorry for anyone who has no choice but to the whims of a nurse, a criminal in a prison or otherwise. This does not apply to male nurses because I have no experience with them. I did have one nurse on the the day before I was released come tell me how I was free to leave if I did not like how I was treated and she was replaced within less than 5 minutes.

These points having been made; I feel sure that this nurse who refused to try to help this dying woman will be punished.

Thanks OP, that really shed some light on the subject for me. I was one of 'them' that responded with blind outrage to the thread you're referencing. I'd link it but I'm using a celly with slowed bandwith (thanks T-Mobile). I never really thought about the circumstances and it never occurred to me that CPR may actually damage a person further, or for some people there truly is nothing you can do besides comfort them. I think the outrage came from the fact that she called 911 for help and didn't help, I guess. If the nurse had made the ethical choice that CPR was not suitable for the woman, why call 911? Guess you don't have time to think in that situation.
My Aunt has a pacemaker, and if she suddenly collapses, idk if I'll do more harm than good now. Very good information there.

Originally posted by MajorKarma
Point in fact, I do not like Nurses. am drawn t being hard on nurses and am drawn to putting them in their place like a cowboy on a green-broke pony. I feel sorry for anyone who has no choice but to the whims of a nurse, a criminal in a prison or otherwise. This does not apply to male nurses because I have no experience with them.

Well, I'm pretty sure if you'd tried that with my youngest brother Billy, he'd have introduced you to what they call "setting limitations on patient behavior". The nursing staff are not your servants, maids, nor butlers, they are not there to do what you demand. They may accommodate you as they can, but the fastest way to get put in your place is to start commanding them to do exactly as you say - you're not medical personnel.

And when you start escalating, that's when you get a code green and the security guys put you in the bed with leather restraints and a mask on your face to stop the spitting. Nothing says you have to be catered to, especially if you're abusive. That's when you're going to discover that PRN means 'when the nurse decides' on that pain med.

Excellent thread. I love learning new stuff.I always suspected that TV writers took creative license when writing scripts for medical dramas.But having zero medical training I wasn't sure.Thank you for a very informative thread.
As for DNR orders i hope to never be in that situation but if I am,my next of kin have been instructed to just let me go.I have no desire to be a vegetable,wasting away at some one elses expense.

Originally posted by Bedlam

Originally posted by MajorKarma
Point in fact, I do not like Nurses. am drawn t being hard on nurses and am drawn to putting them in their place like a cowboy on a green-broke pony. I feel sorry for anyone who has no choice but to the whims of a nurse, a criminal in a prison or otherwise. This does not apply to male nurses because I have no experience with them.

Well, I'm pretty sure if you'd tried that with my youngest brother Billy, he'd have introduced you to what they call "setting limitations on patient behavior". The nursing staff are not your servants, maids, nor butlers, they are not there to do what you demand. They may accommodate you as they can, but the fastest way to get put in your place is to start commanding them to do exactly as you say - you're not medical personnel.

And when you start escalating, that's when you get a code green and the security guys put you in the bed with leather restraints and a mask on your face to stop the spitting. Nothing says you have to be catered to, especially if you're abusive. That's when you're going to discover that PRN means 'when the nurse decides' on that pain med.

I have no doubt that what you say reflects the world you live in but, it might as well be the moon compared to the world I live in.

Originally posted by ohioriver
People who WANT to die already have options.Its called suicide.

No they really don't have suicide. Right now it's ILLEGAL and anyone who helps someone try to commit suicide is themselves commiting a crime. If a person survives the suicide attempt, they can be arrested for attempted suicide. Also, the suicide methods that people use now are painful and messy and difficult. Whereas, having a medical establishment enviornment would make the suicide a MUCH more sure thing .. and a more pleasant experience.

Would you really want the Government (of any country) to be involved with hastening people to the grave?

More like having a medical facility that is available for those who wish to use it.

We help animals along who are suffering ....
People deserve the same choice for an ending if they wish ....