Doctors SHOULDN’T get to “play God” ... AIBU

[MissKittyBeaudelais]

My mum went into hospital as a planned admission, in autumn last year for:-
Medication review
Tests into breathlessness
Physio

Despite admission being arranged by GP, we were told she HAD to go through A&E. She was there around 6 hours and was then placed on a small ward. Whilst in A&E, the Doctor who admitted/examined her talked about end of life and resuscitation. This is standard practice. The Dr. went on and on about what MIGHT occur in the event of resuscitation ie, stroke, fractured bones, brain damage, damage to internal organs etc. My mum insisted that, knowing all this, SHE STILL WANTED TO BE RESUSCITATED. The Dr. continued to push her message and eventually, I asked the Dr. to cease as I felt she was trying to persuade my mum into agreeing to not being resuscitated.

My mum was 79, lived alone, was fully independent and still drove. Her home had two separate staircases and her bedroom was on the top floor. Two days before being admitted, she was shopping in John Lewis for a birthday gift for me and we joked that I hoped it was a suitably expensive and frivolous gift! Remember, she’d gone into hospital for tests. Arranged by her GP. She wasn’t expecting to die. She was put on a ward with MRSA and Norovirus. Ten days later she had got an infection, deteriorated and died.

We requested the medical/nursing care notes as we were not happy with her care. When they arrived, I was really shocked to read the A&E notes in which the admitting Dr stated that both Mrs X and her Next of Kin (daughter) agreed NOT TO RESUSCITATE. I’m fucking furious. I never said that/signed to that. My mother never said that/signed to that. Remember, she was in for tests and physio. She NEVER expected to die. Neither did the family.

AIBU here? Did this Doctor just decide to play God? I remember, when the examination was over, my mum jokingly said “remember Dr, I want anything and everything doing to keep me alive!”

Can a Dr just decide to do this? How does she sleep at night? Ought my Mum/I have been asked to SIGN something to say we agree/disagree?

What would YOU do?

Good luck with your complaint. I hope it brings you want you want.

Alexander I truly hope you’re not a doctor but I suspect you are. I work for the local CCG and have seen many instances of doctors being dismissive of things like deliberately making false statements in notes or dismissing care as “fine” when it’s anything but.

There are some amazing HCPs out there, and there are those who are not. The fact that you are a doctor and cannot grasp why it’s concerning for a doctor to make errors or outright lie in notes is honestly baffling.

OP is a nurse. She knows when care is fine and when it is not. She knows when notes are adequate and when they are not.

The problem here Deathgrip is that we don't know the full picture, we have only the OPs side of things.
You dismiss Alexanders opinions but accept the OPs version of events with question.

If my sister had posted on here and i on another thread, you'd have thought we were talking about care in different countries not the same patient (our mum) in the same hospitals.

If i were the OP i would pursue the PALs route with all my energies and get to the bottom of her concerns, it is something she needs to do, time spent posting on here is pointless, i would also be asking questions of BUPA as to why her Mum was admitted through AE instead of direct to the private hospital for routine tests, she paid premiums to avoid the NHS - as i said earlier, a GP letter is all that is needed.

If the OP is the executor, she can ask for all her mums medical notes too.

The issue is not whether the OP is speaking accurately. We can only assume they are and respond on this basis.

The concern is posters like Alexander who insist that the care outline here was fine and that it really doesn’t matter if records were poorly kept and / or inaccurate because it wouldn’t have had a different outcome in this case. That’s really not the point, and a doctor should know this.

These posters aren’t accusing the OP of being inaccurate. They’re saying there’s no problem with it, when there blatantly is.

Very upsetting. We had a slightly different variation with my father, who had a stroke and lost his sight and ability to talk etc and we visited hospital every day but no one talked to us at all and I found DNR on his notes by chance. I was very upset because although mum and me would have agreed we were not consulted about it: they did not know our viewpoint. When I investigated who had put this on the notes, it turned out someone in Medical Admissions. I did raise the issue with PALs.

However, what I would say, it would have been so much kinder for my father if he could have died on the first stroke and not gone thru the decline of losing his sight, independence, ability to talk and even eat anything other than mushed food because of hiccups at the end and then pneumonia took him at the very end ... I wonder if he had been able to have the choice himself of euthenasia, knowing what he was going to experience in those 18 months whether he would have ... wonderful man who I miss.

Despite certain people going off on tangents, the OP's issue was blatantly clear:

The A&E notes specify that the admitting Dr stated that both Mrs X and her Next of Kin (daughter) agreed not to resuscitate.

The OP was Next of Kin (daughter) and did not agree to this. Mrs X did not agree to this. All the stuff about how quickly she deteriorated is totally separate and the OP - who has significant medical experience herself - has stated that under those circumstances and how her mother had deteriorated she would not have wanted her resuscitated.

This is solely and utterly about an admitting doctor stating as fact in a medical file something that is untrue. And I'd be fucking furious too.

Just to be clear the DNAR is written in the patients best interests if they lack capacity. Ideally family would be spoken to if they are there or called on the phone. Sometimes the form is delayed until NOK is available.
Just to also be clear - euthanasia is actively killing someone and is not practised in UK as it has always been opposed by medical practitioners as it is against everything that we do. It has nothing whatsoever to do with DNAR.
DNAR also does not mean stopping active treatment - that is care decisions in last days of life/ end of life care.

deathgrip - read Alexander's posts first.
You can't criticise her as a poor doctor on no evidence.

Nothing. And I do mean absolutely NOTHING would have induced me to want my mother resuscitated, as she quickly became, at the end. I consider hospitals to be very dangerous places I. Terms of, no one in there is well. All admittances are vulnerable and fragile once they’re IN hospital. So much can go wrong. So much infection. Not all HCPs are of a standard deemed fit to practice. I saw the Zimmer frame on the ward being dragged from one bed to another WITHOUT cleaning. Dr Alexander can dispute this but I know what I saw and when my mum was still of sound mi d, she emailed me to ask me to bring in a supply of Detol wipes so that SHE could wipe things down. I do not care for the attitude that the NHS is totally wonderful and without reproach, it is not.

Oh, and my 96yr old uncle is in another hospital in the UK at the minute. He has Parkinson's. He has pneumonia. He WANTS DESPERATELY to go home. Be with his wife of 77yrs. He wants to die in his own bed. All is in place for him to do this. Last night, I spoke with my cousin. They’re “trying” a different IV antibiotic. My poor uncle is so distressed that they have put bandage mittens on him so that he CANNOT PULL OUT HIS CATHETER AND IV. So, @DrAlexanderHalexander...riddle me this....what the actual f**k is going on in THAT Dr’s mind?

It’s all a mystery to me. Playing God, IMO.

Hi OP
It's not really fair to rant about medical care we know nothing about and you have limited knowledge to us.
We are here to treat the patient.

In the end you didnt want your mum resuscitated.
i am not sure if the doctor was playing god as your title suggests,
it is simply a form for medicolegal purposes
i am truly sorry for your loss.

@EnidBlyton thanks

@mindfulmam... not ranting. Stating my situation within the family is just that. Why do people want to think I’m making things up? I think I’m right; my auntie and cousin are asking that uncle be sent home ASAP. I don’t understand how such an elderly gentleman with a hugely debilitating condition such as Parkinson’s is being effectively restrained and NOT allowed to go home to die. It’s happening. Today. In our NHS. Good grief, don’t we as patients, deserve a say?

Of course he will have a say and doctors will treat in his best interests taking all of it into account.
You can't just dictate on here or in real life what everyone else's treatment should be as if this is some sort of failing of the drs and the NHS.

We treat the patients not family members. Their needs and wishes come first at all times and their best interests.

I have read her posts - what else would
I be responding to?

Just to be clear the DNAR is written in the patients best interests if they lack capacity. Ideally family would be spoken to if they are there or called on the phone. Sometimes the form is delayed until NOK is available.

This patient did not lack capacity when it was discussed. This patient and her daughter did not agree with DNR as the doctor stated they did in the patient’s notes.

That is the issue - do you not understand why this is an issue or are you deliberately avoiding the point?

Your comments are completely irrelevant to the concerns raised by the OP, mindful

@mindfulmam I think I’m done here. But please understand this before I go. MY UNCLE HAS SAID REPEATEDLY he wants to go home. I was down there visiting on Friday and he was totally with it. He knows he’s dying. He’s 96. It’s not ME or his wife/son demanding it, he WANTS it. He’s REMOVING his IV & catheter. He’s not 56 ... he’s 96 and he’s done, as far as he’s concerned. His 94 yr old wife is powerless. If she could, she’d take him home. She can’t “even hold his hand” (her words) because there bandaged up so he can’t remove his tubes. HOW IS THIS in a 96yr olds interest?????

@Deathgrip... you get it. Either they cant, or don’t want to.

I’m done here.

OP the capitals are melodramatic. Can you not leave it to your family to discuss with the treating consultant, by appointment if necessary that's what usually happens. And much better than bringing it up on a public forum.
I understood your post first time round.

Good luck with your investigation. Communication is always key.

@mindfulmam. I’m being melodramatic? It feels like I’m banging my head on a brick wall. My elderly aunt and cousin have discussed with the drs. Drs know what they want. More to the point what he wants. And my bringing this second situation in, I think, demonstrates that patients, especially the elderly are very often not listened to. Or, if listened to, then like my mum’s situation, not acknowledged. If you can’t see that, I’m at a loss. I’m not sticking my nose into family business. My auntie asked me. Ould I speak to them. Well, no. If they won’t listen to the 96yr old, his wife and his son, they’re unlikely to listen to me.

Doesn’t anyone get that?

If your uncle has capacity, he can decide his own treatment, the Doctors can't force anything on him, even if it would lead to his death.
www.nhs.uk/common-health-questions/nhs-services-and-treatments/do-i-have-the-right-to-refuse-treatment/

So, like your original post, doubtless more will come to light on this situation.

I mean we can't verify that - I think if you haven't even spoken to the doctors yourself it's all very third hand.
I think you do need to really calm down.

@MG3C1
your post is not helpful. yes eventually all hearts stop, this does not mean they ccan be resuscitated. You need to be a bit better informed. The point here is that the OP thinks the doctor was playing God. The story does not support this statement

Hmmm so, many people agree with me in the Yes/No vote.

@NoMorePoliticsPlease

Which post in particular are you referring to?