Sorry - what exactly is being suggested here? 'Shouldn't judge'? Is conducting these conversations not now established to be a lawful requirement?
@katemasters67
#HSJPatientSafetyhttps://twitter.com/braemar88/status/1016283271288819714 …
-
-
Psychology / emotion / the things that make us human
-
I'd need to better understand that. Considering all the other psychologically challenging / emotional tasks clinicians undertake, which may quite literally include brain surgery, this seems far from exceptional - not to downplay its difficulty for some.
-
I don’t think you will ever ‘get it’
-
He would, more than most.
-
Ha! Thanks Kate. Although without seeing it several times first hand and talking to those involved, Jill's right - I'll probably never 'get it'. I can't explain it away currently. It makes no sense to me tbh. Real though the phenomenon may be.
-
Its hard to get why clinicians find this convo so hard. I don’t really. I’ve had (too) many people screaming murder at me after a missed/poor DNR convo. At that point, none of the reasons cut any ice with bereaved relatives; they just sound like excuses at that point.
-
As you've said elsewhere - it's a legal requirement. That ought to be reason enough to ensure it happens, badly or otherwise you'd think. But the discussion still appears to be going on this much later, despite the court ruling. I'm genuinely surprised.
-
I have been mostly told that it’s because of the fear of litigation because of the legal requirement.
- 6 more replies
New conversation -
-
-
Well because CPR is the only futile treatment I'm obliged to discuss with a patient
-
It’s also the only non-consented treatment we all expect to receive if needed.
-
I think some patients don’t expect to receive it - they presume we just wouldn’t do it - which is why having to specifically tell them we won’t offer it can feel difficult.
-
I see it as the last bit of a conversation about prognosis and goals - ‘So in view of what we’ve just discussed, it wouldn’t seem right to be doing CPR at the end of your life - would you agree?’
-
That's ok with a competent patient. Sadly many are not and can be difficult to track down relatives at the right time
-
I have a similar conversation with relatives - sometimes over the phone if needed - ‘I’m worried about your relative -what are our aims here? what would your relative say if they could talk with us?’ - but yes, this is why it’s great if things are clarified in the ED - or before!
-
And then the daughter from London turns up the next day "mum's always been fit, I want you to do everything "..... :(
-
This is all part of the dialogue, surely? I do now always ask ‘is there anyone else in the family who needs to take part in this decision, do you think they hold a different opinion? Would you like me to talk to them?’ but patient’s best interests paramount obvs.
- 3 more replies
New conversation -
-
-
Out of interest John what is you backround/experience when it comes to delivering or receiving a treatment escalation planning conversstion or a DNACPR conversation. Id be interested in any insights you have to share be they positive or negative. No obligstion to divulge
-
My personal experience would be of limited relevance on this subject tbh - 1 such example with my father that barely qualifies, as he was the one who instigated the conversation we'd known was coming for 23yrs anyway. Hardly a typical example.
End of conversation
New conversation -
Loading seems to be taking a while.
Twitter may be over capacity or experiencing a momentary hiccup. Try again or visit Twitter Status for more information.
