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C7RKY's profile
John Clarke
John Clarke
John Clarke
@C7RKY

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John Clarke

@C7RKY

Of course views all mine. All without prejudice. Just a regular chap after all. Oh...and RT's may equally imply ridicule as endorsement.

UK
Joined December 2011

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    1. Mike Stone‏ @MikeStone2_EoL Jan 13
      Replying to @C7RKY @KaraChrome

      The best way to try and ensure that the record of a conversation is 'accurate' is to get whichever party to the conversation did not write the record, to sign the record to confirm that it appears to be right. BMA/RCN/RC(UK) are resistant to that, however.

      1 reply 0 retweets 1 like
    2. John Clarke‏ @C7RKY Jan 13
      Replying to @MikeStone2_EoL @KaraChrome

      Not in this case, it's not. The signature doesn't make a jot of difference in mitigating the risk I'm talking about here I'm afraid - as acknowledged by CQC/NHSE/GMC. If you read the articles I linked to before, it will hopefully explain more.

      1 reply 0 retweets 0 likes
    3. Mike Stone‏ @MikeStone2_EoL Jan 13
      Replying to @C7RKY @KaraChrome

      Ah - you are interested in 'remains' accurate?

      1 reply 1 retweet 1 like
    4. John Clarke‏ @C7RKY Jan 13
      Replying to @MikeStone2_EoL @KaraChrome

      Exactly! As opposed to the form being vulnerable to later amended, in order to try and justify any clinical action - or inaction - that was not in keeping with the consent obtained.

      1 reply 0 retweets 0 likes
    5. Mike Stone‏ @MikeStone2_EoL Jan 13
      Replying to @C7RKY @KaraChrome

      Well - if you design a better form, you would have the problem of the entire form being substituted for a faked one. I suppose you would need to store copies of completed consent forms in a 'trusted third-party repository' as soon as the form was completed? Unlikely to happen.

      1 reply 0 retweets 0 likes
    6. John Clarke‏ @C7RKY Jan 13
      Replying to @MikeStone2_EoL @KaraChrome

      3rd party not necessary. Some measures can prevent amendment, but the greatest protection comes from ensuring that the form makes it clear the pt should take their copy immediately after signing it, imho. Can't switch/amend it unnoticed, if the patient has a copy at home.

      2 replies 0 retweets 1 like
    7. Mike Stone‏ @MikeStone2_EoL Jan 13
      Replying to @C7RKY @KaraChrome

      Keeping a copy makes sense - but all of this (your issue) is about 'distrust' when you think about why it is necessary: distrust is a very poor foundation for good care/behaviour, especially during end-of-life at home [as I keep pointing out, in BMJ rapid responses].

      1 reply 0 retweets 1 like
    8. John Clarke‏ @C7RKY Jan 13
      Replying to @MikeStone2_EoL @KaraChrome

      1/2 You're right, this stems from being given reason to distrust, but it's also about regulation. My mother & I trusted implicitly however, as most do. And it transpires that it's possible to abuse that trust. Potentially systematically & at scale, when you look at the evidence.

      2 replies 0 retweets 0 likes
    9. Mike Stone‏ @MikeStone2_EoL Jan 13
      Replying to @C7RKY @KaraChrome

      1/2 You cannot 'have a process to cover my major issue': an EoL patient at home, explains to a family carer late one evening 'I've now reached the point when I definitely don't want anyone to attempt CPR' but. before that has 'reached the records' the patient arrest and the

      1 reply 0 retweets 0 likes
    10. Mike Stone‏ @MikeStone2_EoL Jan 13
      Replying to @MikeStone2_EoL @C7RKY @KaraChrome

      2/2 family carer calls 999, explaining 'my dad made it clear to me last night, that he doesn't want CPR if his heart has stopped'. Either the 'mindset' is that 999 should believe the carer, or else not - currently it is 'to not believe the carer' which angers me!

      1 reply 0 retweets 0 likes
      John Clarke‏ @C7RKY Jan 13
      Replying to @MikeStone2_EoL @KaraChrome

      To use your word from earlier - tricky. Not all families have the same dynamic, so protecting the pt's right to life over the undocumented word of a relative? Yeah... just tricky. Hopefully not too many happen in such a short window like that?

      5:55 AM - 13 Jan 2018
      1 reply 0 retweets 0 likes
        1. New conversation
        2. Mike Stone‏ @MikeStone2_EoL Jan 13
          Replying to @C7RKY @KaraChrome

          The point is - listening to 'I really would prefer to be dead now. from your dying dad, 'has a deep impact on you': subsequently being 'accused of lying' by 999 leaves you rightly 'furious' if you are [and surely most would be] one of the honest family carers.

          1 reply 0 retweets 1 like
        3. John Clarke‏ @C7RKY Jan 13
          Replying to @MikeStone2_EoL @KaraChrome

          I can entirely understand that. Fewer times can be more emotional in life already, without the added insult of such an accusation. I'm sorry if that was your experience.

          0 replies 0 retweets 0 likes
        4. End of conversation

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