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#1 | ||
Lucky Jack
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This is wrong, this not a decision a nurse should take and I don't care if she has 20 years experience under her belt. Only a Doctor has the knowledge to make the call on such issues and this is without doubt a bad move by the BMA.
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#2 |
Soaring
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It depends on how "suitably experienced nurses" gets defined and is understood.
Also, having practiced in a hospice, and a hospital with a separate station for the dying myself for several months, I want to stress this description in the article: "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. " That was not my experience, for I was no medic and did not work in such departments of the hospital where such emergencies would happen all that often, but seeing those being old often dying in loneliness, in denial of their understandable personal wishes (or in illusions about their situation) - and in contrast the hard reality of a routine-running hospital - it makes me think about dignity and uselessness in that context, too. the one big wrong with our modern medicine is this: most people think it is worth it to live as long as possible, no matter the financial and life quality costs. And that is the source of great tragedy in modern time. that's why I would refuse and actively resist any procedures pushing me into such a direction once my time has come, and I also would not accept to go into hospital if I would knew it is just for dying this time. For me, making certain decisions myself is the choice I made. We prolongue our lives, and live longer and longer, but nobody dares to speak out about the price that means for families. Partners, and children. For societies, for the younger generations living in them. The price is heavy, believe me.
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#3 | |
Ace of the Deep
![]() Join Date: Apr 2002
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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...
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the world's tinyiest sh3 supermod- ![]() and other SH3/SH2 stuff http://www.ebort2.co.uk/ The best lack all conviction, while the worst Are full of passionate intensity. W.B.Yeats Last edited by CB..; 10-27-07 at 08:34 AM. |
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#4 |
Soaring
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Again, it depends on how "suitably experienced" is defined as.
I do not comment on the number of doctors in the health care system, i do not know it for england, for germany I know that more and more absolvents of university leave germany as fast as they can, because the bad working conditions for hosital doctors here. Many of them run duty for 36 hours and more. I know of people being on duty for 40 hours. do you want to receive surgery by such a fella? Would you do his job with such killer-shifts? what I do say is that it is not only a question about technical competence, but human empathy, and human qualities as well. And here I have seen doctors performing much worse than some of the nurses. and believe it or not: many dying people, wether they be old ones, or young victims of accidents in the emergency, seek human warmth and comfort before everything else. It is not always just about technical treatment. to make technical skills exclusively the deciding criterion wether somebody is geiven legal authority to decide if efforts taken are being to continued or not, has turned the modern medicine into the cold, inhumane business many people perceive it as. Leaving one day we all must. Question is wether we do it yelling, struggling and hysterically flailing around wildly - or just differently. And this is what all to often decides between misery and dignity.
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#5 | |
Ace of the Deep
![]() Join Date: Apr 2002
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which will have the exact opposite effect to that mentioned in the guidelines... topsy turvy thinking...simply to avoid the expense of employing sufficient numbers of doctors and consultants to do the job properly...this is why these soloutions arouse such suspicion..because all it serves to do is temporarily distract the public from the genuine problem...all that will result from these guidlines is that senior nurses will leave their jobs and go else where as you described..just as the doctors and consultants have..lowering the quality of care even further and escalating the pressure on those who remain.. and so it goes ever on employ sufficient numbers of doctors and consultants and the whole system will begin to work again as it was intended with happy staff and better standards of care...the "impossible" soloution of course as it costs money..money the authoritys consider better spent elsewhere....the rest is just "spin doctoring" and to emphasise the point what are the pay/working conditions of the countrys "spin doctors"? the powers that be have laid their cards on the table...their prioritys are clear
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the world's tinyiest sh3 supermod- ![]() and other SH3/SH2 stuff http://www.ebort2.co.uk/ The best lack all conviction, while the worst Are full of passionate intensity. W.B.Yeats |
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#6 |
Chief of the Boat
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I agree with STEED
![]() What next ?....."In the event of a suitably qualified/experienced nurse not being available a student in there final year of training who has so far attained A+ grades in a recognised blah blah blah " :hmm: |
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