to think this is disgusting and wrong

[threeOrangesocksmorgan]

here
surely the man and his family should have had a say before this was put in place .
how can it be right?

'That would imply that whatever condition sent him into hospital in the first place was curable.'

From the article, he went in to have the PEG tube fitted. BUT, if the procedure had gone wrong, requiring resuss, would his dementia and possible other health matters mean that resuss was unsuitable? We don't know. He developed pneumonia. This can result in the need for resuss in many patients, but would this be contraindicted due to his health? Again, we don't know.

Without being in court, it's hard to know why exactly that was issued and I think it was wrong for it to have been done without consulting the patient and his family.

There are plenty of people who have good quality of life, but they have health conditions which mean resuss would be life-prolonging rather than life-saving for them.

If I had read this article prior to her having gone through what she did, Cailin, I'd have been able to see only one side. But, having lived with her in hospital for so long, and met so many parents of children not just with cancer but other conditions (only few of them life-limiting but plenty in which their child would not survive resuss/mechanical ventilation - HLHS, heart conditions and some with CF, for example).

It's entirely possible this is completely discriminatory, and so the suit will probably go forward, but it remains to be seen then, in court, what the full background is.

Sadly, it is sometimes the case that people who are even now enjoying a good quality of life have health conditions in which resuss and ventilation will ultimately rob them of a more peaceful death, too .

CailinDana

We did complain at the time and had a family interview with the young doctor where we strongly told him how badly we felt this had been handled. In the end it probably would have been better if my mum had just been able go and not be resuscitated, it was the callous manner it was dealt with we had issue with. We weren't looking for blood but wanted the doctor to learn and consider his words and actions and how they affected real people. If my mum wasn't going to be resuscitated, I don't understand why she needed to be told that, we as a family needed to know the situation but she had already told us she wanted to be ignorant of how much time she had left and the finer details.

We had a similar issue when she was first diagnosed and they were waiting
for the tests to tell us the whole prognosis and how bad it was. Another young doctor mislead us by guess work, raising our hopes slightly that it wasn't the worst case scenario (we were happy to wait for the results) only to have to backtrack when the results finally came in and it was as bad as it
could get.

Sorry for going slightly OT but even four years later it can still kick you down.

Begonia, how awful! We had three doctors in ICU who definitely had no business delivering news to families, tbh, and, having been an old pro at taking very bad news, I made sure they knew that. If we hadn't been so battle-hard by the time we got there, they would have, well, they were good clinically but needed to hand over some things to others, frankly. A simple, 'You may not realise this, but your tone is coming across as extremely callous and insensitive, and I've had enough experience of grave news to deduce that. If this makes you uncomfortable, I'd be happy to wait for handover or please ask Prof X (our consultant) or Dr Y (her consultant) to discuss in your place.'

I had one start to discuss her in the room! Yes, she was ventillated and unconscious, but I stopped him immediately and said, 'Excuse me, but I find it highly unprofessional to discuss this type of information in front of the patient, please let's continue this conversation outside,' and proceded to take him by the arm and lead him out!

Imagine if you got one of those people when your child took that ill without having a prior health condition! They'd be your first exposure to the world of hospitals. Dreadful!

I'm sorry if this has been mentioned, but the thread moves fairly fast,

but there is a huge difference between not for active treatment and not for resus, you can be NFR and FOR active treatment, which means that

also, when I Dr puts someone at NFR that does not mean they think they will never recover, its about their current condition and whether resusing them in their CURRENT state might mean recovery or death after ages in ITU, its quite normal for people to be NFR for a while, then for it for a while, then NFR, that has no impact on whether they actively treat or not

When someone is NFR but still for active treatment EVERYTHING will be done to stop them from crashing in the first place, right up to the point where they actually stop breathing/heart beating

its just that how many on here are describing NFR criterias and outcomes on here sounds more like Not for Active Treatment criterias and outcomes!

So are we all agreed that the main issue here is the lack of communication with the patients family ? That by coming to the decision of DNR the Drs have an ethical duty to discuss their decison with the family so they can understand the reasons for doing it ? That the family finding out second hand via a piece of discharge paperwork is wrong and must of been deeply upsetting for all those involved ? That putting the fact that the patient had DS ( without further explaining any medical relevance) was at best lazy and at worst predjudiced?

Orange , would love to build a bridge but the toddler has buried the hammer somewhere in the garden !

I have to say that even if the Dr's being on the ward didn't coincide with the family being on the ward , we still have that wonder of modern technology , the telephone . It would have taken a minute to find the NOK telephone number in the admission paperwork and make a phone call . Even if the NOK details were not in the paperwork , then i am sure an obliging nurse would have rung the home and found the details for them .

Thanks for clarifying that, bits.

"It would have taken a minute to find the NOK telephone number in the admission paperwork and make a phone call"

they do, but if there's no answer it would be wrong to leave a message, also wrong to leave too many missed calls at a time when someone is in hospital.

But nursing staff would be on the ward when relatives visited , so they could have organised a meeting with the Dr's or a phone conversation with them . He was in hospital for two weeks !

visitors don't always announce themselves, they pop in and out at visiting hours

OK i know that , but if the Dr's ask specifically for a meeting with relatives , then you generally keep an eye out don't you ? Or is that just me ? I am sure that at some point during a two week admission some one could have found a relative and arranged a discussion with the team .

He was there for two weeks! Easy enough for the trainees on morning rounds to make it clear to his family that the cons wanted to speak with them, or the other staff.

To be fair expat , on an adult ward the visiting hours tend to be around the 2-4 and 6-8 , unless a person is critically or terminally ill .

Dont get me wrong abit , i know that on an afternoon you can be up to your armpits in jobs and looking out for specific relatives comes way down on your list of priorities , but if you let the CSW and domestic and ward clerk know aswell , then surely between the lot of you , it is achievable ?

There has to be some way, over a fortnight!

nurses can't spend an hour twice a day "keeping an eye" on a particular bay if they have 2 bays and 3 siderooms each. They're not sitting in a bay each all day, they're in the treatment room drawing up drugs or in siderooms or behind curtains in other bays most of the time and there's not even enough time for them to do that! I'm sure they were "keeping an eye" as much as they could but its not physcially possible to keep an unbroken watch until someone happens to come in - most people aren't visited at every visiting time!

ward clerks aren't usually on during evening visiting, they do more like office hours, and support staff are in the kitchen or behind curtains or in the sluice getting bedpans too.

There's rarely a proper reception on most wards, and even on the ones that do have a proper reception desk that everyone passes on the way in, they either keep going and don't introduce themselves (they don't have to sign in) or the reception is office hours only and evening visiting is usually after dinner

Yes i know all this , i am a nurse . But still , two weeks ? Sorry to go off on a tangent but the whole not leaving a message thing doesn't make any sense does it ? Surely there should be a process of verifying a number to NOK , so you ring till you get a reply , then make a note that the number is verifyed and then a message can be left . Also not sure if this is the same with all trusts but if we ring out from the ward , the number comes up as withheld , a lot of people won't answer a withheld number .

A person with lds and dementia will have a named contact, either a carer or a family member, to assist with his care. There is no way a non competent adult would be left in hospital with no contact.

no messages left in this trust, too open to panic and misunderstanding!

and 2 weeks does not necessarily mean 24 visits! it could have been one or two visits!

Is it a withheld number bits ? The family stated that they were in just about every day though , even if they exaggerated and only came half the time that is still 7 visits . Don't get me wrong , i am not here to slag off the nursing staff , i know how hard it is .

Its possible that the named contact wasn't a family member though, we dont know.

I do understand what you are saying bits , i spent the last ten years working on a ward where i spent at least eight of those wondering why i hadnt trained as an OT instead

yes its a witheld number to ring out, but even so any large number of missed calls when you have someone in hospital can make you think the worst even if you don't see the number