If anything it makes them a better one, recognising their limits. A poorly lead discussion can do untold damage. @jhartin
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With respect, a poorly delivered, (or undelivered), general anaesthetic can do untold damage too - but we don't let people skip over that step with patients because they've had a bad experience previously. It's a skill like any other which must be mastered to be competent, imho.
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I don’t think anyone is saying not to do it; what I / we are asking is to support staff properly. You wouldn’t ask the dermatologist to give a GA. However the dermatologist might retrain, and be well supported during the training, in anaesthesia.

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DNACPR isn’t anyone’s speciality, could that be part of the problem?
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That's true, but this is not really a change of discipline for me. All treating clinicians must be able to communicate relevant info to pts already. For consent, if nothing else. If discussing death is the problem, then maybe the insurance industry can help - they do it every day
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Or the funeral industry, or crematorium staff.
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Quite. Certainly not something I'd expect to be beyond the abilities of a trained clinician tbh. And if it is, then the training needs to be reflected upon, imho.
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Yes – I don't see why discussing DNACPR should be more difficult than other discussions about other treatment options to plump for or not. Eg discussing not to offer surgery to someone who the clinician doesn't feel it would benefit?
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Many reasons why a person may not be able to have a conversation. A traumatic experience with a patient ir relative before for example. This is not saying the conversation should nkt happen but they have to ask a colleahue to help them. Tgis does not make them a poor clinician
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I’m not comfortable with that. If a clinician identifies someone as being at risk of cardiac arrest/dying and CPR won’t work, how long do you give them to get help? Straight away? Next shift? Never?
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The last part of this tweet sums it up for me - relatives don’t have the option of opt out. We have to trust that the medic will do their job to protect us. Support both sides of the fence is vital, but give an inch of an opt out and we will back where we were before it was law.pic.twitter.com/YUjgmubFnN
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Sorry to butt in here... Isn’t only a medical role, experienced nurses/HCP’s can initiate & conduct these important communications. Each case & how the situation is handled is influenced by a multitude of factors, no one-size fits all. Folks want info ASAP.
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Good lord. Absolutely. Anyone who is unable or unwilling to have these conversations has no business working in a job in which they are necessary. I might add that relatives do not have the option to simply opt out of the consequences of a really tough situation.
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Some Dr's shouldn't put ADRT DNACPR in notes of patient on discharge that is not up to a Dr that's legal binding and is up to individual. And DNRCPR form should be discussed with patient and family but sadly still not being done. end of life care drug's needs toxoligy report's
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