DNR issues

[paris2]

Patient was due to go to operating theatre when i looked in her notes to ensure that everything was in place. I found a note written by SpR that patient "does not want to be resusitated" if anyhting goes wrong in theatre. No nursing staff were aware this entry.

Although i questioned and acted upon very quickly, could you imagine if this was not picked up what could have happen?

Some drs are playing dangerous game.

[XB9S, BSN, MSN, EdD, RN, APN]

THis most definately should have been communicated to the nursing staff, we would usally make sure that a member of nursing staff was present with the patient and relative during the discussion about resuscitation.

Just one other question do you use collaborative notes as we have found that this helps communication as you are all working from the same documents.

[paris2]

THis most definately should have been communicated to the nursing staff, we would usally make sure that a member of nursing staff was present with the patient and relative during the discussion about resuscitation.

Just one other question do you use collaborative notes as we have found that this helps communication as you are all working from the same documents.

No we don't have collaborative notes: drs notes are seperate from nursing notes.

We did trying to work towards care pathway document but was not very popular with drs given the nature of medical conidtion. Saying that, as a clinical nurse specialist i was too sure with the idea of care pathway document.

Nontheless in this situation you are correct, it should have been communicated to the nursing staff. Dr was not sure he had to do this and has now shown a proper policy, though the long document he had no time read.

[XB9S, BSN, MSN, EdD, RN, APN]

No we don't have collaborative notes: drs notes are seperate from nursing notes.

We did trying to work towards care pathway document but was not very popular with drs given the nature of medical conidtion. Saying that, as a clinical nurse specialist i was too sure with the idea of care pathway document.

Nontheless in this situation you are correct, it should have been communicated to the nursing staff. Dr was not sure he had to do this and has now shown a proper policy, though the long document he had no time read.

I think saying he wasn't sure that he had to communicate to nursing staff is a really poor excuse, all docs should know if they want to get things done (or not as in this case) that the nursing staff are the most important people to be communicating to, without informed nurses how does he expect his patient to get the treatment he wants and at SPr level I think this is unacceptable. Had he been one of my Sprs I would have had a word with his consultant about his poor communication.

[paris2]

I think saying he wasn't sure that he had to communicate to nursing staff is a really poor excuse, all docs should know if they want to get things done (or not as in this case) that the nursing staff are the most important people to be communicating to, without informed nurses how does he expect his patient to get the treatment he wants and at SPr level I think this is unacceptable. Had he been one of my Sprs I would have had a word with his consultant about his poor communication.

Yes i will be having a word with his consultant and will be informing my manager to ensure that this issue has been addressed in their management meeting to ensure that all drs are aware of hospital guidlines and procedure related to DNR issues.

[Clarecartwright]

I mean the REG should of made it clear wether she was for a call or not - By stating her wishes it doesnt mean that he wants her not for a call ! Wow well done picking that up :)

[RGN1]

Well done for picking this up! It absolutely needed to be & should have been communicated to the nursing staff. I hope the doc learns from this & well done you again!