#NurChat to discuss the nurses role in discussing and deciding DNAR 23/8/2011 8pm Tweet
The NurChat discussion subject for the 23rd August at 8pm is “The nurses role in discussing and deciding do not resuscitate and the ceiling of care” This subject was suggested by @safer_ICU - thank you.
The NurChat discussion subject for the 23rd August at 8pm is “The nurses role in discussing and deciding do not resuscitate and the ceiling of care” This subject was suggested by @safer_ICU - thank you.
As nurses we often find ourselves caring for patients who have DNAR clearly documented in their notes. The decision to not attempt resuscitation on a patient always rests with the most senior clinician involved in their care however as nurses we are often at the forefront of care and know the patient and family well to advocate their wishes and choices. There are some areas where nurses are positively encouraged to initiate DNAR discussions, this empowerment of nurses means that the patients can be properly cared for do not need to suffer unessary and inapropriate CPR, however this does not always happen. Sometimes, even once the patient DNAR status has been decided there are further issues that present within the care of the patient … where does active treatment stop and how much are nurses involved in the decisions on how patients are treated and when treatment becomes solely palliative?
If you want to do some reading before the discussion here are some links to interesting articles and advice:
Decisions relating to cardiopulmonary resuscitation - A joint statement from the British Medical Association, the Resuscitation Council (UK) and the Royal College of Nursing
NMC Guidance on resuscitation
A review of nurses' attitudes towards DNAR decisions – Nursing Times
Communication failure prevented a patient dying with dignity – Nursing Standard
Ethical aspects of withdrawing and withholding treatment – Nursing Standard
http://nursingstandard.rcnpublishing.co.uk/archive/article-ethical-aspects-of-withdrawing-and-withholding-treatment
Do Not Attempt Cardiopulmonary Resusitation (DNARCPR) Integrated Adult Policy - NHS Scotland
http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/LivingandDyingWell/ShortLifeGroups/-DNACPR
Summary by Teresa Chinn RN
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Post Chat Summary
Do Not Attempt Cardiopulmonary Resusitation (DNARCPR) Integrated Adult Policy - NHS Scotland
http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/LivingandDyingWell/ShortLifeGroups/-DNACPR
Summary by Teresa Chinn RN
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Post Chat Summary
This discussion was very a lively and emotive subject. We had a lot of different areas of nursing discussing DNAR. The discussion mostly looked around how we as nurses can feel empowered to not only discuss DNAR with doctors but also with patients and relatives. Different areas of expertise had different views on the criteria for DNAR which led to some interesting debate! We also discussed the importance of acting as an advocate and some useful links to end of life care and the Liverpool care pathway were tweeted.
Thanks to all who took part and to @safer_ICU for the suggestion. Please feel free to share the transcript of this chat with your nurse colleagues or to add further comment below.
Summary by Teresa Chinn RN
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Chat Transcript (Reverse chronological order):
Summary by Teresa Chinn RN
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Chat Transcript (Reverse chronological order):
2 comments:
Excellent chat tonight. Just a suggestion - what about some guidelines for people on use of #nurchat and @? Sometimes I couldnt see all the conversation nor did I know if I was doing it right! Anniecoops XX
glad you enjoyed it .. Yes we have this in the pipeline already so please watch this space ! Thank you for the feedback it's always appreciated
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