Quote:
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"The new guidelines, which cover hospitals, hospices and ambulances, were introduced because some experts feel that sustained rescuscitation efforts can be undignified and often worthless. "
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now this is the trouble with guidelines such as this....they sound fine on paper (or not as the case may be)
but what are they really saying....?
if you consider the inclusion of Hospices in the guidelines...and consider what purpose Hospices serve....frequebntly they are there primarily to cater to the needs of those patients who are dying and for which there is no cure likely...they are admitted because they are going to die and the facility and staff are there to administer care and make them comfortable during this sad time...
ok....so allow a senior nurse to decide wether or not to attempt to resuscitate a patient..in a hospice...why would this be neccesary? where are the Hospices consultants? where are the Hospices doctors during this time?
why can they not be bleeped and called to the bed side? in a Hospice where this situation is not only normal it is actualy part and parcel of the Hospices main function....they know every single one of their patients are going to present this dilema at some point in their "stay"
what this instruction is actualy saying is that we have not employed sufficient doctors and or consultants to do the job...and that in fact especaily in a Hospice ..the facilty is neglecting the needs of it's patients...
rather than employ more doctors it is more "cost effective" to allow a senior nurse to take over the responsibility even tho they have not been trained to handle this level of direct responsibility nor to make clinical decisions regarding wether a patient is liable to benifit from a resuscitation attempt or not...it is rediculous to expect senior nurses to make such decisions without the proper training and support....and most likely will only result in senior nurses becoming over pressurised and reluctant to make these decisions...are we to assume that the nurse will allways decide not to resuscitate? or are we to assume the nurse will allways decide to attempt to resuscitate?..what in practical terms will happen is that the nurse will err on the side of self preservation (both professionaly and emotionaly)
and will nearly allways decide to attempt to resuscitate....disregarding the patients genuine needs and dignity completely because the consequences of making the wrong decision are too great...senior nurses do not have the back up that a doctor or consultant has..all they have is their union..their is no genuine protection for senior nurses...and living with the responsibility on top of all their other resonsibilitys will no doubt drive senior nurses out of their chosen profession ..which will result in what advancement in patient care one wonders..(another crisis 5 years down the road with another stupid soloution)
no what this guideline is really saying is that we're too cheap skate to employ sufficient doctors to properly provide a genuine service...but because we do have enough money to employ sufficient "spin doctors" we can word the guideline like this to hide this negligence behind weak emotional manipulations...