Opinions about UK nursing issue

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

Over here we have recently had a statment released from the British Medical Association and the Royal College of Nursing about decisions regarding resuscitation.

I know that different countries will have different legal and medical systems but I wondered what your opinions about the statement would be.

It can be found HERE

It is a long document the bit of particular interest is page 19, section 13 responsibilities for decision making.

13. Responsibility for decision-making

The overall clinical responsibility for decisions about CPR, including DNAR decisions, rests with the most senior clinician in charge of the patient's care as defined by local policy. This could be a consultant, GP or suitably experienced nurse. He or she should always be prepared to discuss a CPR decision for any individual patient with other health professionals involved in the patient's care. Teamwork and good communication are of paramount importance. Where care is shared, for example between hospital and general practice, or between general practice and a care home, the health professionals involved should discuss the issue with each other and with other members of the healthcare team. There should be shared responsibility for deciding about the likelihood of a successful outcome from CPR, and discussing the issue with the patient or with those close to patients who lack capacity where a balance of benefits and burdens is needed. Nevertheless, one individual needs to take charge of ensuring that the decision is made properly, is recorded and is conveyed to all those who need to know it, including locum staff. Local policies should specify who that should be.

[RN1989]

I like that it says that SOMEONE should be taking control of the situation and discussing this with patients or families. Too often I see people being kept alive in a miserable state because either the doctor can't let go, or everyone is too afraid to approach the family. I've been in battles with doctors who were unable to let a patient go, even when the pt and the family were begging to stop treatments and go peacefully. I've had to refuse to follow doctor's orders because the pt declined the treatments but the doctor just couldn't give up. When I get the right "feel" for the situation and believe it is in the best interest of the pt, I don't have a problem discussing a code and what CPR and all that entails. I've had many docs get angry because they don't feel that this is my place. I like this document because it says that it the place of nurse to do so.