DNR

[penz1]

My dad is in hospital,I was asked if I had filled out a Respect form. I asked the nurse today and she said they have placed a DNR notice up.

I am against this but was told that they have decided.??

[bantam12]

If the Drs consider resuscitation futile and in their opinion it will not work they can put a DNR in place.

Difficult for the family but it's what is best for the loved one that matters.

[MirandaBS in reply to bantam12]

There is a duty for medical practitioners to consult with the patient / family on DNR decisions. It does not sound as if you have had a meaningful discussion. Ask to speak with the consultant / Dr / Matron in charge of your father’s care. If you remain unhappy, ask to speak with the Medical Director or Chief Nurse.

[Motorman]

On 17 June 2014, the Court of Appeal ruled in Tracey v Cambridge University Hospital NHS Foundation Trust [2014] that there is a legal duty on medical practitioners to involve and consult patients when placing a ‘Do Not Resuscitate’ (DNR) order on their medical files.

Giving the leading judgment, Lord Dyson stated that a ‘convincing reason’ would be needed in order for a practitioner to not involve a patient. This might be where the doctors felt that consultation on the use of a DNR notice would cause a patient physical or psychiatric harm, though it was added that causing mere distress to a patient is not a sufficient reason to exclude them. (Source keepcalmtalklaw.co.uk/has-t....

A dear friend was treated in a less than ideal manner in a local hospital. She had signed a DNR . There were aspects of her treatment that could be construed to have shortened her life.

I will never sign a DNR as a result of this experience.

MM

[Ansteynomad]

My husband had Power of Attorney for his mother which contained specific instructions (no hospital admission, no treatment to prolong life etc). My husband was also asked to sign a Respect form on her behalf. In the end, both care home and hospital ignored both!

[Hidden]

Could I ask what is wrong with your Dad and what is his prospective outcome or quality of life likely to be if he does need resuscitating?

[RufusScamp]

It is a very hard situation. Having to say "Let him/her die" is not easy, but when you look at what resuscitation involves, you might be glad not to have to choose.

I had to make this decision for my beloved father 25 years ago, and it still hurts to think about it.

[SpiritoftheFloyd]

DNR or to give it the full title Do not attempt cardiopulmonary resuscitation (DNACPR), is putting a process in place that if the patient stops breathing or their heart stops beating then no intervention takes place to try to recover the patient. Some people think it means not to intervene at all, but it just relates to stopping breathing or the heart stopping beating - all over medical care is carried out as normal.I have had a cardiac arrest and had 5 minutes of CPR to get my heart beating again. Luckily it worked, and even more luckily I survived pretty much unscathed. Most CPR attempts fail, and for those where CPR works, the patient is frequently badly damaged as a result of it - broken ribs, punctured lungs and due to the body having being deprived of oxygenated blood, brain damage, which sadly can be severe and leave a patient in a much worse condition that there were in prior to the event. This is why doctors attempt to put DNACPR notices in place. What they are saying that they, in their professional opinion, believe that if your father should go into arrest CPR would not prolong his life or would do you more harm than good.

I'm sorry that you find yourself in this very distressing situation.

Below is a link to the NHS site

nhs.uk/conditions/do-not-at...

[Milkfairy Heart Star in reply to SpiritoftheFloyd]

Thank you, SpiritoftheFloyd for your honest insights of the realities of being resuscitated.

[Hatchjd]

I was a nurse for many years. A common misunderstanding people have is that CPR (calling a code or resuscitation) will keep patients alive and living as they were before. Sadly, this is not the case, if someone is very frail or chronically ill enough to cause the heart or breathing to stop, resuscitation will not change the underlying condition and the process will likely cause further damage. I have seen some discussion online about changing the terminology to AND-Allow Natural Death instead of DNR which does seem kinder. My 88 y/o aunt is currently hospitalised with severe Covid, lung clots and a poor prognosis. On admission the hospital discussed with her the pros and cons of ventilation if needed. She declined and placed a DNR on herself. She made this decision as in her own words she had had a wonderful life and didn't want to live her final years where she was fully dependant and couldn't wipe her own bum. She was still assessed by the ICU team to see if ventilation would help when her condition worsened, but she was not a suitable candidate as the chance of a good outcome was poor. This decision has not stopped her from receiving excellent care, treatments and medications... or improving. Today she was sitting up eating ice cream.

[Mentdent]

Sometimes DNR is very clear and obvious to all but this isn’t always the case as your question obviously demonstrates. It’s a hugely complex and emotive issue which is why everyone possible needs to be consulted.

[richard_jw]

I had a heart attack just over a year ago. They did an angioplasty and the care I had was outstanding. I had to be readmitted with Pericarditis a day after they discharged me.

I had to wait in A&E until a bed became available in the ward.

A senior doctor arrived at my bedside, and started asking questions effectively setting me a test (e.g. can you recite the months of the year in reverse order).

I finally cottoned on that this was preparatory to a DNR being effectively thrust upon me.

I'm 70 and the heart attack is the only problem I had. I asked this doctor if this was all about a DNR, and he finally admitted that it was. So I sent him away.

Had I not been alert and in full possession of my faculties, I do believe that a DNR would have been forthcoming.

A few months later, my GP asked me about this event. It appears that in the midst of Covid DNRs were being thrust on patients for no good reason, and the NHS was trying to assess the potential reputational damage.

I believe this practice has at least been kept in check.

[Hidden]

My son was involved in a serious road accident 2 years ago, and had internal injuries which led to sepsis. We were warned that his chances were very slim, and one doctor explained to us that if he went into cardiac arrest, they would not resuscitate him, because all his organs were failing and it would be pointless. It's a very, very, hard thing to hear, but we could understand why they came to that decision. Thankfully, after 5 days on a ventilator and a dialysis machine, he slowly started to recover. The doctors were amazed. It's been a long, hard, fight, and he still needs another operation, but he's finally getting his life back. The doctors fought hard for him. Even when they thought it was a losing battle, they didn't give up. I still feel sick when I think of that conversation, but I know that if he had arrested, no amount of CPR would have revived him. I'm just glad I wasn't the one who would have had to make the decision. I hope no one has to take it for your dad.

[Handel]

I have to say that my dad's doctor contacted me (dad had late stage Alzheimer's and was 96 at the time). It was me who asked about DNR and we spoke at length. He was grateful that I said dad needed a DNR in place. I couldn't have put him through the strain of CPR and rather he passed away peacefully. Dad passed away this year from Covid after he was admitted to hospital with a leg infection.

I hope you get the information you need. Thinking of you. Jan xxx

[Shar28]

Hello, I’m so sorry to hear about your dad. It’s an upsetting and worrying time. Knowing a DNR had been placed is distressing but in my experience understanding why is the key as others have already said. I say that because my mum sadly died last year at the age of 91 after being admitted to A&E as an emergency. The Dr asked my sister if mum had a DNR, which she didn’t. The Dr also explained that unless they could identify the cause of her collapse that day and something could be done to fix it then CPR wouldn’t work. In fact, it could cause her great distress if it worked briefly then failed or worked and left her brain-damaged or disabled. As it happened, mum arrested, CPR was attempted and failed because there was no electrical signal from the brain.

We were both distraught at the thought that DNR was the best way forward for mum, but understanding why helped and if mum had survived that day she would probably have wanted a DNR herself. We know that because the autopsy results showed that she was about to be very frail, fatigued and indeed disabled. She would have needed care, probably in a residential setting, for daily living and intimate care, which she would have hated.

I hope that whatever happens your dad isn’t distressed and you find your path through this emotional time.

[Hidden]

Here is an interesting fact bout DNR’s - they’re only known about at the place in which they are placed - otherwise I would be dead!

I found out earlier this year that my GP Surgery records showed a DNR had been issued for me. My Cardio NP found out when they were upgraded to System One (where records a shared across hospitals and GP’s within a trust are - I think).

She enquired as to when it had been placed and by who. I suggested it might’ve been the OHS Surgeon, because op I pretty much didn’t recover (figures include flatlining 3 times in 1 hour one day, 20 times in 24 hours another day) whilst in a Coma), Surgeon advised that there was a point where they had done all they could to keep me alive but I had ‘pulled through.

On contacting my GP Surgery, it transpired that a GP had put it in place whilst learning how to use the computerised system a few years earlier, by mistake. Whilst conveying apologies etc, they also admitted that had the CTC from another trust who performed my surgery known about the DNR there was every chance I may not have received the operation - or been resuscitated on those many occasions.

Given that during my stay, family were asked to come and say their goodbyes on a couple of occasions, I am glad that the trusts do not communicate such things openly, even if the DNR was put in place accidentally.

Hope you get your issues resolved in a way that is acceptable to your family.