D.N.R Interesting post, what are your... - British Heart Fou...

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D.N.R Interesting post, what are your thoughts?

Lizzie20 profile image
35 Replies

U.K Only

If, at any stage, you feel pressured into agreeing to sign a DNR statement, refuse.

"If there is no lawful basis for the decision systematically to deny life saving treatment to a person or group, the clinicians making the decisions may be subject to criminal law sanctions (murder or manslaughter), as well as civil claims for assault, clinical negligence, and discrimination amongst others."

[ . . . ]

"However clinicians are then told to consider comorbidities and underlying health conditions in all cases. Of particular concern in the context of disability is that at the critical point clinicians are told to refer to consider two specific co-morbidities: Cardiovascular comorbidity, defined as fatigue, claudication, dyspnoea or angina at rest due to myocardial or peripheral vascular disease ; and Respiratory comorbidity, defined as permanent shortness of breath with light activity due to pulmonary disease or use of home ventilation (excluding CPAP for sleep apnoea)."

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Lizzie20
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35 Replies
Milkfairy profile image
MilkfairyHeart Star

Hi Lizzie20

Could you please provide the reference for the quote in your post to help give a context to the words?

You may find this information from the Resus Council of the UK helpful.

resus.org.uk/dnacpr/decisio...

Doctors sign do not resuscitate forms.

theguardian.com/commentisfr...

Lizzie20 profile image
Lizzie20 in reply toMilkfairy

I've just been put on Ranolazine meaning it can cause dizziness. My question is if I'm out and I collapse would I be taken straight to the covid ward with a D.N.R, it's a frightening thought.

Milkfairy profile image
MilkfairyHeart Star in reply toLizzie20

Lizzie20

Why do you think this would happen?

The NHS is still treating non covid patients and they are kept separate from patients with covid.

The article from the Guardian I posted gives a very clear account of how patients are being cared for it is written by a doctor.

I suggest if you have ongoing concerns you discuss this issue with your GP, Cardiologist or ring the BHF helpline and speak to one of the Cardiac nurses.

0300 330 3311

Stay safe and stay well

Danceawaytheblues profile image
Danceawaytheblues in reply toMilkfairy

I was admitted to a cardiac ward via ambulance last Sunday. My hospital has

green and red areas, including green A&E. Very reassuring.

bantam12 profile image
bantam12

I have had to discuss DNR on several occasions when my late husband was in ITU, at no time was there any pressure or persuasion to agree, the staff don't like talking about it anymore than the patients and families.

I don't really see the point in your post, everyone's situation and medical issues will be different so the decision is not a straightforward agree or not agree.

orangefish profile image
orangefish in reply tobantam12

who are you to just dismiss what is obviously someone,s genuine concern with a legitimate question,, of coarse all situations are different but thats not for you to make a judgement

Alison_L profile image
Alison_L in reply toorangefish

Orangefish, please don't snap. Lizzie20 has said she is worried that if she collapses in the street with dizziness, she will be taken straight to a covid ward with a DNR. As others have said, there is no reason for this to happen.

Stay safe and be kind to others.

bantam12 profile image
bantam12 in reply toorangefish

I have answered not dismissed, if you don't like my reply just move on past it, no need to be rude 😊

IMAGES profile image
IMAGES in reply tobantam12

I agree with you bantam12, the post is irrelevant.

Prada47 profile image
Prada47

Hi

I have just read the links milkfairy has kindly posted, and now have a better understanding of the difference in CPR as a general Medical Treatment and the difference in DNACPR which is a Doctor lead Situation.

Personally I wouldn't want Resuscitation if it meant my quality of life was going to be Poor after the Resus. Which I think is the $64000 question would they know before the attempt !! I don't know if that makes sense to anyone but it does to me .

Stay Safe Stay Well

bantam12 profile image
bantam12 in reply toPrada47

They have a very good idea if resuscitation is wise or not and generally if that conversation is happening the prognosis is not good either way.

Prada47 profile image
Prada47 in reply tobantam12

Agree 100% bantam

Stay well Stay Safe

Sunnie2day profile image
Sunnie2day in reply toPrada47

Have you made your feelings clear to your medical team? It is helpful to have preferences on record - just in case - so families and medics are all on the same page in an emergency.

My dad had one of the first patient request DNRs back in the mid-1980s. My brother and I weren't happy about that, btw, but it was his preference and he made it clear to us and the doctors by putting it in writing even before his COPD and CHF (congestive heart failure) progressed to the stage of being in CPICU (cardio-pulmonary intensive care unit) for over a month.

Sad to report the night the doctor told us he was doing so well they were planning to discharge him in 48 hours, he flatlined despite being on a heart and lung machine while my brother and I were in the canteen celebrating over a cuppa.

The medics ignored the huge DNR sign over his bed and worked on him 45 minutes trying to bring him back. They called it at that 45 minute mark, we argued it should be when he flatlined and they did agree in the end to use that time as his TOD (time of death).

It's different nowadays - a pre-signed DNR order is very rarely ignored. If you want one, get it in order now before it's needed - and make sure your loved ones are on-board however reluctant they may be about it. Saves family members trying to overrule your preferences should it come to the point of it being a matter of urgency.

Prada47 profile image
Prada47 in reply toSunnie2day

Hi Sunnie

First time I came across DNR was when I was admitted to the Methodist Hospital in Jackson MS. I was diagnosed with a bleed on the Brain (Leaking AVM ) they tried to stop it with embolization which really slowed it down but not a permanent solution. That came later with a Gamma Knife procedure !!

That's the background. It was whilst in the ER that I was asked did I have a " Living Will " I had never heard the expression Living Will but it turned out it was a DNR wish that I signed !!

Stay Safe Stay Well

Prada47 profile image
Prada47 in reply toSunnie2day

Hi Sunnie

Follow on from DNR

I do need to ask the question do they keep you going even thou you have died, before they take the bits. I understand what I mean smiling not exactly lol.

I was going to leave just my Heart for research when I die, I have been told it would be useful after living for 38 years after an initial MI followed by having CABG in 2015. Then thinking about it they can take Heart and Lungs and Brain. I don't want to give my whole body simply because it can take up to a year before the family get it back for cremation or burial, depending on your preference. What helped me decide was I was willing to give any bits for Transplant donations but don't think my heart or lungs would be any good and everything else is almost worn out !!!

Take Care Stay Well

Sunnie2day profile image
Sunnie2day in reply toPrada47

I've thought about leaving organs to research, I'm still pondering it. I plan to be cremated so if they want anything they're going to need to grab it quick after I'm declared.

As for transplants, oddly enough even with my heart conditions (mild-ish and medically and lifestyle controlled) they apparently are happy to have my liver, kidneys, and lungs, and I've been told skin and eyes would be appreciated as well despite my being a tri-focals wearer since 2002. I've been informed my body would be kept on a machine until harvest but TOD would be when they declared me dead and prepped for harvest.

Blimey, what a topic of discussion for a spring afternoon!

bantam12 profile image
bantam12 in reply toSunnie2day

My Dad was going to donate his body to research but he was rejected, don't know why.

Sunnie2day profile image
Sunnie2day in reply tobantam12

I was told mine would be welcome as I'm a woman but my husband as a male would not be as they always have a surplus of older white male cadavers. Apparently not many women of any race and very few non-white males donate their bodies to science so they're usually happy to have someone from those groups donate.

I hope I've not offended anyone by referring to sex and race as donor preferences to research centres.

bantam12 profile image
bantam12 in reply toSunnie2day

I had to decided what happened to the bits that were taken from my husband during his post-mortem, there were several options so I went for the teaching and research one, threw me a bit at the time as I wasn't expecting to be asked !

Prada47 profile image
Prada47 in reply tobantam12

You Lovely Lovely Woman

Thank You

Prada47 profile image
Prada47 in reply toSunnie2day

Sunnie

No one could be offended when we are talking about what could be life saving research. If they are they can go away 4 and 3 the 4 across begins with F and 3 down begins with O now if that offends sorry.

Beautiful Afternoon in Dorset.

Stay Well Stay Safe

Prada47 profile image
Prada47 in reply tobantam12

Hi Bantam

I was told by a Heart Nurse once her Father had donated his body but they rejected it because they had enough already and was full !!

Stay well

Stay Safe

Lizzie20 profile image
Lizzie20

Sorry the link wouldn't post earlier.

cloisters.com/resuscitation...

Prada47 profile image
Prada47 in reply toLizzie20

Excellent link a little hard work to get through, but I now think that I have a better understanding of the reason for your initial post.

Need to revisit the article to understand the Disability aspect. I never classed my Heart Failure or Shortness of Breath as a Disability !!

Stay Safe Stay Well

My late father had COPD and a heart valve replacement but was healthy in that he could walk one mile each way to his nearest shops in Bristol. He developed dementia in his last year after being 'lost' in a hospital for two days when he had a chest cold. They put him in a room on his own and then forgot.

As a result, his family GP whom he had been seeing for over 20 years said he should sign a D.N.R. which my father agreed to as my mother had died in agony over 3 days due to a mix up with hers. The problem was the doctor. I was home looking after dad at the time and three times over a month the doctor appeared, uncalled for, in the evening to ask my dad to sign but he chickened out and said he was just calling to check on dad.

He eventually gave dad the form when waiting for his last trip to hospital. The doctor was actually tearful afterwards which was upsetting.

Dad spent 6 weeks in hospital and he caught Norovirus whilst waiting to go into a care home and died of that, not the COPD.

His doctor sent a condolences card and coincidentally retired the following week which seemed early.

I just wish my doctor in London had a fraction the care and humanity of my dad's doctor.

horac profile image
horac

this whole matter depends on the confidence you have in the NHS?

Ilovebunnies profile image
Ilovebunnies

Hi Lizzie20, something I have been thinking about for quite some time & think it's probably been talked about as well. Does anyone else think it should be compulsory to be given an organ donor card when you pass your driving test ? If you (the person who passed their test would have to sign to say they don't agree). There are still too many people who haven't even heard of organ donation (spare parts). Maybe being a blood donor could be done the same way. I've had my wishes for being an organ donor put in my will. Sorry it's so long. Enjoy the sunshine, stay safe & well. Chris .

Anxiousarabella profile image
Anxiousarabella

My husband was took to hospital with breathing problems. He was put in a and e which only had a curtain separating covid and non covid patients. Then he was put in a ward with people who they was not sure had it or not. They were tested and then next day given results. His was negative but two people were positive. While he was there - he spoke to a man who tested positive - all he had wrong before this was constipation - yet he was asked to sign a DNR. My husband thought it was awful and this man was terribly upset about it. My husband was then moved to a Respiratory Ward so he did not find out if he signed it or not. My husband has now said he won’t go back into hospital.

Milkfairy profile image
MilkfairyHeart Star in reply toAnxiousarabella

You may find this information from the Resus Council of the UK helpful

resus.org.uk/dnacpr/decisio...

Doctors sign do not resuscitate forms not patients.

The Guardian article describes what Cardioplumonary resuscitation CPR involves.

CPR is not a trivial treatment . Doctors usually initiate DNACPR discussions with patients when they fear CPR would be futile.

theguardian.com/commentisfr...

Here is an example of the form commonly used by the NHS

images.app.goo.gl/t2im6rjuT...

Anxiousarabella profile image
Anxiousarabella in reply toMilkfairy

Thanks for the info Milkfairy. Maybe the man in question was asked to agree to DNR as I know he told them that he would have to discuss it with his wife as he could not make the decision on his own.

2-10-0 profile image
2-10-0

Correct me if I am wrong but I was advised that they harvest organs whilst you are still alive. I was told by someone who worked in the NHS that you are still on a life support machine and people move when the organs are taken. When the machine is turned off and you are dead it is too late to harvest the bits and pieces, except eyes and skin I believe.

2-10-0 profile image
2-10-0

I will never sign a DNR form because people make mistakes and misjudgements even doctors. I saw a friend placed on the LIverpool Care Pathway because he was a bed blocker. An eminent Judge called it murder.Just google Liverpool Care Pathway and see the horror stories. Thousands of elderly people are also liquidated in Belgium every year without consent because Euthanasia is legal there.

Prada47 profile image
Prada47 in reply to2-10-0

Hi

I believe but not 100% the Liverpool Pathway has been discredited and is no longer used ??

Stay Well Stay Safe

Coco51 profile image
Coco51

This is a very complex subject but I suggest there is no harm in filling in the Advance Care Plannng form provided by the NHS adding your medical history, information about yourself, your interests, levels of activity, your life, and stating your wishes on resuscitation. Keep it somewhere where it can easily be found if you need to go into hospital eg with your meds. At least your wishes will be known, and there will be a basis for making decisions on triage. england.nhs.uk/coronavirus/...

Lizzie20 profile image
Lizzie20

Thank you for all your replies. I feel my post is relevant considering the difference in replies. We all need to consider our options for the future.

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