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?

I agree NurseJackie, it appears to me to be a completely alarmist and factually incorrect piece. It's mixing DNR with not treating at all. They're not the same thing from my understanding. And I highly doubt that the man cited had a heart attack and was not treated. Often the terms heart attack and cardiac arrest are used interchangeably, when they're clearly not the same thing and have completely different treatment pathways. I am fed up with these constant articles on so many subjects, education, politics, the economy, the NHS, that are designed to whip everyone up into a frenzy all the time.

I'm not talking about the OP but I do think some of the inflammatory comments are not helping the situation.

I dont thingk the notes were falsified, the decision was dnr. A patient can request a dnr themselves but not to expect resus if it is not clinically justified.

This is not the same thing!

A doctor can decide that resus would not be medically indicated.

A doctor cannot

A doctor cannot just record that a patient’s wishes are for DNR when they are not.

I’m stunned by some of these responses.

Well death grip, we haven’t seen the notes. It might say something like: DNACPR discussed with patient and daughter. Futility explained.

Well obviously we haven’t seen the notes so we can only base responses on the OP, which was written by a very experienced nurse. If she’s misrepresented the notes that’s a very different scenario, but that’s not what PPs are saying.

Totally agree with NurseJackie and Greenwings
The scandal is that families are "playing god"and demanding/threatening to get ever more unnecessary medical treatment for elderly,frail patients with zero quality of life rather than face their own issues with death and dying.
Obviously this doesnt apply to you OP and Im very sorry to hear that your DM died so suddenly and it must have been a terrible shock for you
The most likely explanation is that the GP suspected a serious underlying condition and that this was the case.
I saw so many elderly patients admitted suddenly, having been independent, with stage 4 cancer that had
minimised their breathlessness,pain or symptoms, particularly to their families.
The most likely explanation is thedoctor made a mistake (particularly in the initial absence of a Respect form) or your DM spoke to them again after you had left.
Ive seen that many times.
Best wishes to you OP

@AutumnRose1... sorry, definitely not ignoring you. I agree, she was treated badly. So we’re we. I’m not sure I have the wherewithal right now. And as many have said, it won’t really change anything.

Thank you for your input 😊

I'm very sorry for what you've been through. It's very traumatic to see a loved one going to hospital for what is considered not urgent and not making it out.

However, a lot of what you post doesn't make any sense. GPs can't refer directly to an acute ward, at best they can only do so for community beds in a community hospital.

It also makes no sense to admit a patient in the NHS with the expectation to transfer them to BUPA. It sounds like your mother was much poorly then believed. As others have said, DNR would involve a written and signed form.

Arrange to meet with someone in the hospital who can guide you other what happened and you can them make up your mind whic failures have taken place.

YANBU. After my mum died we discovered she was "DNR" . This was never discussed with any of us. We didn't do anything about it as it wouldn't bring her back, and I bet loads of people feel that way, but if this seems to happen a lot maybe more people should make complaints to stop it happening to others.

www.thesun.co.uk/archives/news/1165094/are-doctors-using-do-not-resuscitate-as-a-backdoor-to-euthanasia/

That article is scaremongering, scary fir patients to read, untrue, badly written and not factual.
The law does not say patients or families have to agree , it is a medical decision but families should be informed.
And to infer doctors are secretly flouting the law and leaving people to die is insulting inflammatory and outrageous.

Oh dear God !
What absolute nonsense.
News flash !
We are all going to die -we seem to have forgotten that dying is as normal as being born.
We need a rethink and far more education surrounding this .

I dont think the dnr is the issue I would say it's the recording of it that's the issue if they misrecorded by accident what else did they do? And why? Tiredness led my doctor to put the wrong dose on my prescription my less sleep deprived pharmacist spotted it and things were adjusted to prevent it happening again my daughters wrong dosage wasnt spotted however but fortunately the school were negligent and didnt give her the medication so she wasnt double dosed the phone call hows your daughter? has she been sleepy? Is never something you should get for a four year old

In the past before DNR forms existed a medical decision would be made as to if it was in the patient's best interest. Then litigation became a big thing and patient's would be resusitated to avoid any legal action - elderly people were having their rib cages broken etc. The DNR is just a form to show clearly why the medical decision to not resuscitate has been made. It is there to protect patients from the devestating effects of resuscitation when not in their best interests.

I am honestly so shocked that people are so quick to dismiss and misrepresent this.

This is not about whether resus is in a patient’s best interests or not. This is about misrepresenting a patient’s wishes in official records which should always be factual. At the very least there should be some investigation into whether misrepresentation occurred here or not. The implications for making false statements in records is enormous.

@MissKittyBeaudelais - it sounds like your mum's care was not up to scratch at all. I do wonder, though why you didn't help your mum into clean clothes? I find it a bit odd sometimes when on a ward the nurses/hcas are rushed off their feet and a family member doesn't help the patient to get changed/feed them etc. Not blaming you atall just wondered.

@Deathgrip - I see your point that medical notes should always be factual and that didn't happen here. It could call in to question what else might be incorrect in the notes. That is a valid point. I think it's just that regarding DNRs it wouldn't have changed anything whether the doctor had written they agreed or not. But yes, I take your point.

@Cynthie...no. My mum would not have done this. In her mind, she was experiencing some breathlessness and was NOT dying. I think she was shocked that the Dr. was even suggesting that her condition was so poor that she would not be considered fit for “trying to save her”. Had she, she’d have insisted on coming home with me, immediately.

@Rachelfromfriends1... my meaning of “playing God” is this. A lady is a planned admit due to breathlessness. No heart failure, no pulmonary disease known, fit up to this breathlessness and self caring. And yet .... DNAR assumption made. A bit like a previous Dr. commented earlier “At that age, I wouldn’t attempt CPR”. My mum’s auntie died at 88. She walked everywhere and had been dancing at the British Legion the night she came home. Climbed the stairs to her bedroom and had a massive stroke. AGE and some sudden unaccountable breathlessness should NOT mean you don’t fight for the patient’s life.

@jasjas1973... underfunding. Well, it’s IS a cause of fucking WONDERMENT that the Tories who’ve floored our services in the past ten years have been voted in again. We need to stop sending money/aid to China and India and drag our own welfare into the 21st century. As for the admission route... I’ve NO IDEA. It was the consultant at BUPA who said to go via the local hospital. Transfer was arranged the following day (ambulance booked) but the Norovirus/MRSA contagion stopped it.

@EmeraldShamrock... thanks love.

The GP said “I feel we’re missing something” and she was admitted
That's the crux of the situation.Patients don't get admitted for respiratory tests, medicine review and physio. Ever. She was admitted because the GP, and most likely subsequently, the doctor who assessed her in A&E knew that there was something probably very wrong with your mum to cause the breathlessness.

It sounds like the notes were poorly recorded, but that doesn't mean that care wasn't provided appropriately. Could she have been suffering from sepsis before she got in?

Sue the shit out of them.

We wouldn't really admit someone with mild breathlessness for investigation. All GP referrals go through the ' acute take ' or emergency pathway. There must have either been a clinical diagnosis of heart failure, or an abnormal Chest x ray or at least some debilitating or significant sob that couldn't be looked into in clinic otherwise that just doesn't make sense - only unwell or unstable patients are admitted or a suspicion there is something serious going on. Maybe the GP didn't give all of the detail and was being reassuring?

Re the conversation and documentation - as everyone has said, no one should put an incorrect summary in the notes but they might put ' DNAR discussed with pt and family' . Did they issue a DNAR form on that day ?

Greyandcopper
That is so offensive

@UndertheCedarTree ... we asked but mum wanted a shower and they wouldn’t let us. Eventually, I insisted on changing her so, we used a bowl at the bedside. My sister visited the next day in the evening and my mum was confused, the clothing I’d put on her the day before, with food slopped down it and she said her mouth wasn’t clean. Again, my sister helped her. By this time she needed more help. She was confused and getting worse. Her foot stool had gone to the lady next door and her legs were swollen. So much so, that they thought she had a clot formed in her leg (DVT). It wasn’t that.

@Misskitty - your poor mum - basic care is so important

Hi OP
Could you say whether and when the DNAR was written if you know