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Do not attempt cardio pulmonary resuscitation (DNACPR) - confusion


Claire Cox

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It has been in the news of nurses not wanting to perform CPR on patients who were frail and in nursing homes - https://www.nursingtimes.net/roles/care-home-nurses/the-implications-of-an-nmc-caution-for-nurse-who-did-not-perform-cpr-26-06-2017/ written by @Ken Spearpoint.

I have heard of a different problem.  There was a  patient that did not want to be resuscitated, they had a form, it was discussed with them and their family.   However, the form was deemed not valid as it was not signed by a consultant with in the 72 hours.  The patient subsequently arrested and had to be resuscitated due to the from being 'invalid'.

What are your thoughts on this and what can be dont to prevent this from happening ( I'm sure this isn't an isolated case)

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Hi Claire, this must have been awful for everyone. Is this a legal requirement, that a consultant must sign a form?  

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Those model forms have been designed around the requirements of the healthcare provider and healthcare professionals. Should we perhaps have forms that have been designed from patients' and relatives' perspectives?

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35 minutes ago, Jonathan said:

Those model forms have been designed around the requirements of the healthcare provider and healthcare professionals. Should we perhaps have forms that have been designed from patients' and relatives' perspectives?

It would be so useful if advance care planning documents including DNACPR and ReSPECT were coproduced with patients and families. I understand the need for clear forms, easy to read in a hurried situation, and that are concise and to the point, but I do feel coproducing future documents with patients like myself who have a life-limiting condition and who have had these conversations and used other versions of ACP documents, and current and former carers with this lived experience, would enable far better - more representative - documents to be created that make sense to patients and families and not trying to fit us into a form but designing a form that allows everyone to be accommodated. I'm not saying a new design for everyone -- but designing them around what makes sense to the patient cohort and carers/families, who all understand the need for ACP, have personal lived experience and want to give back in whatever way they can. 

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