Without wishing to demonise our medical colleagues, I just wanted to offload. Having spoken to a sprightly lady in her 90s about discharge plans and support once she went home, I duly popped into her medical record to write up our conversation.
Guess what I found?
Not for Cardiopulmonary Resuscitation
Discussed with patient? No
Discussed with family? No
Reason for decision, including clinical rationale: Advanced Age.
Signed: Dr Indecipherable Scribble, Registrar.
Is this our new caring, person-centred health service? Or the same old 'Doctor knows best and old people are a waste of our valuable time and should just die already'?
Grr.
Absolutely appalling. Have you taken it up?
Intend to after consulting with my manager in the morning as to whom to approach to get the right (or any) reponse. As I am precisely six working days into this post, still working out where the battle lines are and who the generals may be.
Shirack: Absolutely appalling. Have you taken it up?
As soon as I've spoken to my manager in the morning. Only six days into this team and unsure yet who to go to with this in the NHS hierarchy to get the right/any reponse.
P.S. if you get another reply under a new name, I'm going into deeper cover for various reasons. Will probably the nix this one.
If you get nowhere this is a 'Whistle-blowing' matter which you can not ignore as it strikes at the very roots of care.
Rupert M: If you get nowhere this is a 'Whistle-blowing' matter which you can not ignore as it strikes at the very roots of care.
You have a penchant for stating the bleeding obvious. As Mary is taking the appropriate steps, there was no need for your input, or are you just trying to get your strikerate up, as you delight in accusing me of?
Shirack: Rupert M: If you get nowhere this is a 'Whistle-blowing' matter which you can not ignore as it strikes at the very roots of care. You have a penchant for stating the bleeding obvious. As Mary is taking the appropriate steps, there was no need for your input, or are you just trying to get your strikerate up, as you delight in accusing me of?
I found it quite helpful, actually. Sometimes the obvious can do with a little re-statement. Can we leave off the feud, chaps, you agree on the principles after all...?
Hi Mary,
I was horrified your post, and having a gut feeling that this is far from an isolated case, I had a quick foray on Google and found this article from the BMJ, dated April 2000:
http://www.bmj.com/content/320/7243/1155.full
(Hope the link works)
Anyway, best wishes to you in following this up and may I suggest that if there isn't a clear process for addressing it after you have discussed it with your manager, try contacting Age UK for advice and guidance - the article indicates that back when it was still Age Concern this was a matter they were actively involved in pursuing.
Please keep us updated (whether incognito or not!).
Given all the economic pressures we must fight to ensure that the rights of the most vulnerable are not sacrificed on the alter of economics - Mary has raised a vital issue which strikes at the interface between Health and Social Care and exposes the tensions which can, and do, arise within multi-disciplinary settings.
What is the 'capacity' of the elderly person - would it be relevant to 'encourage' her relatives (or even herself) to enquire about access to medical records?
Does the elderly person have capcity to make a 'living will.?
Given the social work Code of Ethics is this an issue which ought to be raised with the GSCC for Policy Guidance?
Reported via my manager to one of the hospital Clinical Supervisors. Will keep you posted if, as and when I get any feedback.
Maryeldon: Reported via my manager to one of the hospital Clinical Supervisors. Will keep you posted if, as and when I get any feedback.
All the best with it.
For interest, we had a meeting with the Minister Paul Burstow on Wednesday and raised the issue of inappropriate use of DNAR. We have asked him to write to all Trusts and remind them of the national guidance on the use of DNAR, which he indicated he would consider doing. Keep an eye out for it, it might help to change the culture. (Action on Elder Abuse)