The most common myth I have heard is this one. In an unnamed ITU it was noted, with great concern that on a particular weekday (let us say Thursday) that patients were dying with alarming regularity.
The management looked into this of course. It was discovered that Thursday was the cleaner's day for doing a deep-clean.
Of course! The cleaners were UNPLUGGING THE RESPIRATORS to plug in their vacuum cleaners:eek:
Some families will still insist on everything being done, no matter what the doctor says. I blame shows like Grey's Anatomy that show someone coming out of a Code in perfect health with no left over deficits. (cough Izzie cough).
I know exactly what you're saying, and you're right, but there are those rare ones....
I have actually taken care of one individual who came out of asystole and lived to tell about it. Is still telling about it, actually. And he appears to have no side effects (AND he's over the age of sixty).
At my last hospital he is literally a legend in his own time. We were all pretty much in awe of him!
In medical decisions, "fact-based" can be highly subjective. Many, many DNR situations are not the aged, frail, grandma and grandpa. Our laws favor the individual, or the family is best placed to make a decision between life and death. The theory being that this eliminate's cost factoring. Since we treat everyone equally under the law, the system will have people who are aggressively resuscitated as well as younger people with a better quality of life. No one likes to see a code as an exercise in futility, but calling it "abuse at the very least" in a legal sense is way over the top. If it was taken further, what would that be? Criminal charges for attempting to save a life? I don't think so.
The doctor in the US does have the authority to "pull the plug", and sometimes they do against the wishes of the family. A person who is clinically brain dead can't be kept on a ventilator for an indefinate period of time, for example. Cases involving the withholding of nutrition and hydration wend their way through the court system with heated opinions on both sides. It's a messy system sometimes, but the principle behind it is a good one.
I have a home care patient who is ventilator dependent but is leading a rich, full life. Would a doctor who doesn't know her be the best person to decide her code status? The most important thing to do is make sure, that we, ourselves have advance directives and try to encourage our family members to do the same.
Perhaps abuse is harsh however there could be criminal charges if a patient was deemed unsuitable and cpr left them brain damaged, the family would have the right to demand an investigation. The statistics for in hospital resus attempts are that 15% survive the cpr and a third of them die within 3 days.
The damage that can be caused during cpr on a patient who is terminally ill and would probably not survive anyway would break the hyprocratic oath and break ethical healthcare laws since health care professionals have a duty to be non-maleficent, which means "first do no harm" cpr would be causing more harm than good, more pain and ultimatlely an undignified death.
In the UK the only person that can authorise DNR status is the most senior clinician involved with that patients care, in hospital it would the consultant who would see the patient every day, in the community it could be either be the GP or a the Senior Community Nurse.
In the UK we strive to be patient advocates, we try not to go into a state of paternalism because this impunes on patient autonomy, we have dicsussions early on in patient care on advanced directives so they may make the decisions reguarding their care.
There was a nurse in Glasgow who came across on of her patients collapsed at the hospital door, she performed cpr, got help and saved his life, however she also broke a couple of ribs. Criminal charges were brought against her.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
There was a nurse in Glasgow who came across on of her patients collapsed at the hospital door, she performed cpr, got help and saved his life, however she also broke a couple of ribs. Criminal charges were brought against her.
*** How horrible for her. I would like to say that wouldn't happen here (USA) but I can't say it wouldn't. In all the hospitals I have worked at DNR patients wear something to identify them as DNR so staff who may not know that patient do not try to preform CPR on them.
Perhaps abuse is harsh however there could be criminal charges if a patient was deemed unsuitable and cpr left them brain damaged, the family would have the right to demand an investigation. The statistics for in hospital resus attempts are that 15% survive the cpr and a third of them die within 3 days.
The damage that can be caused during cpr on a patient who is terminally ill and would probably not survive anyway would break the hyprocratic oath and break ethical healthcare laws since health care professionals have a duty to be non-maleficent, which means "first do no harm" cpr would be causing more harm than good, more pain and ultimatlely an undignified death.
In the UK the only person that can authorise DNR status is the most senior clinician involved with that patients care, in hospital it would the consultant who would see the patient every day, in the community it could be either be the GP or a the Senior Community Nurse.
In the UK we strive to be patient advocates, we try not to go into a state of paternalism because this impunes on patient autonomy, we have dicsussions early on in patient care on advanced directives so they may make the decisions reguarding their care.
There was a nurse in Glasgow who came across on of her patients collapsed at the hospital door, she performed cpr, got help and saved his life, however she also broke a couple of ribs. Criminal charges were brought against her.
What happened with the nurse in Glasgow who was sued for broken ribs? I think she should countersue.
What happened with the nurse in Glasgow who was sued for broken ribs? I think she should countersue.
I think the family got compensation or the broken ribs guy did, the NHS paid it though and I believe the nurse actually didn't get much more than a surprise. But she was investigated, and I think she had to do retraining and stuff.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I think the family got compensation or the broken ribs guy did, the NHS paid it though and I believe the nurse actually didn't get much more than a surprise. But she was investigated, and I think she had to do retraining and stuff.
*** If that happend to me.... boy you sure would not want to be the next person I come across in need of emergency care. I might think about it for a while.
also when the baromter drops...like before a hurricane...
See, that I don't doubt. They've proven we have circadian rhythms and how depression increases in the winter (possibly related to the shorter days). I think we're more in tune with nature than some would like to believe.
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dhaylecs
3 Posts
All hospitals have a legend. I work in a hospital and if you drop cutlery they all freak out... they believe admissions will double for your shift.