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Nurses to make life and death decisions

#1
For the first time in the history of the profession, senior clinical nurses have been given the authority to decide whether or not patients should be resuscitated.

The official guidance, issued by the British Medical Association, started a fierce debate last night. Although some medical professionals welcomed the new rules, patient groups voiced concerns that they could place unfair pressure on nurses.

Previously, only consultants and doctors of General Practitioner rank had the power to decide not to resuscitate. However, under the new rules, "properly experienced" clinical nurses will be able to make that judgement.

The BMA's guidance is partly in response to the Mental Capacity Act, which came into force earlier this month. This introduced the concept of a living will, which allows patients to state in advance their wish not to be resuscitated in the event of their heart or breathing stopping, or to choose someone to make the decision for them if they are incapable of doing so.
http://www.telegraph.co.uk/news/mai...FWAVCBQWIV0?xml=/news/2007/10/27/nurse127.xml
 
#2
Now this raises an interesting point. Has it been made so that nurses can authorise a DNAR (Do Not Attempt Resuscitation) order solely on the basis of the 'living will' (i.e. if the patient requests it) or have they been given equal authority with consultants and GPs to write a DNAR on clinical grounds without patient consent?

The former is acceptable, I don't think the latter is.
 
#3
Indeed - I'm pretty much on the fence at the moment.

Surely the nurses work too closely with the patients to make decisions like this? As in, if a nurse is working closely alongside a patient she does not like, it would probably be difficult for her to seperate that from making a professional decision?

Also, I know the standard of doctors varies, but I've met some nurses who probably wouldn't even be able to finish a degree in media studies - so not sure they should be allowed this amount of power.
 
#4
amazing__lobster said:
For the first time in the history of the profession, senior clinical nurses have been given the authority to decide whether or not patients should be resuscitated.
The official guidance, issued by the British Medical Association, started a fierce debate last night. Although some medical professionals welcomed the new rules, patient groups voiced concerns that they could place unfair pressure on nurses.

Previously, only consultants and doctors of General Practitioner rank had the power to decide not to resuscitate. However, under the new rules, "properly experienced" clinical nurses will be able to make that judgement.

The BMA's guidance is partly in response to the Mental Capacity Act, which came into force earlier this month. This introduced the concept of a living will, which allows patients to state in advance their wish not to be resuscitated in the event of their heart or breathing stopping, or to choose someone to make the decision for them if they are incapable of doing so.
http://www.telegraph.co.uk/news/mai...FWAVCBQWIV0?xml=/news/2007/10/27/nurse127.xml

Changing demographics and medical advances will mean increasing numbers of elderly patients who are expensive to care for and slow to die.

Just a bit of pre-emptive back door euthanasia intended to become routine at ward level......
 
B

Biscuits_AB

Guest
#5
Well I hope this is just some more Torygraph spin, as my first and hopefully last encounter with an over promoted nurse (Nurse Practitioner), nearly killed me.
 
B

Biscuits_AB

Guest
#6
amazing__lobster said:
Indeed - I'm pretty much on the fence at the moment.

Surely the nurses work too closely with the patients to make decisions like this? As in, if a nurse is working closely alongside a patient she does not like, it would probably be difficult for her to seperate that from making a professional decision?

Also, I know the standard of doctors varies, but I've met some nurses who probably wouldn't even be able to finish a degree in media studies - so not sure they should be allowed this amount of power.
Let's see (if indeed this is true) how this stands legally. Will a nurse be deemed to have the education and experience by which to determine life or death?
 
#7
It's an interesting one. Last time I was in hospital a Dr came in to have a look at me, totally ignored the nurse that was there, looked at some notes and then had to ask the Nurse why he was there.

There are far more brilliant nurses than sh*t ones and don't forget that an F Grade nurse will often have way more experience than an SHO.

T C
 
#8
John_Charity_Spring said:
Changing demographics and medical advances will mean increasing numbers of elderly patients who are expensive to care for and slow to die.

Just a bit of pre-emptive back door euthanasia intended to become routine at ward level......
I think you're right, and I don't like the idea of a nurse having the right to kick my bucket.

If this is allowed give it another year and this government will allow the cleaners to make the decision.
 
#9
They kill enough patients with simple, sloppy, clinical practice. (Hand washing...)

This can only enhance their value in their own eyes and take them further away from the actual job they should be doing which is wiping arrses in a correct and timely manner
 
#10
Biscuits_AB said:
amazing__lobster said:
Indeed - I'm pretty much on the fence at the moment.

Surely the nurses work too closely with the patients to make decisions like this? As in, if a nurse is working closely alongside a patient she does not like, it would probably be difficult for her to seperate that from making a professional decision?

Also, I know the standard of doctors varies, but I've met some nurses who probably wouldn't even be able to finish a degree in media studies - so not sure they should be allowed this amount of power.
Let's see (if indeed this is true) how this stands legally. Will a nurse be deemed to have the education and experience by which to determine life or death?
Theres been too many KILLER nurse stories in the press over the last few years and if this comes in could lead to more being put under increasing pressure. The only way this could work properly is first that the Senior Nurses are in the majority of wanting it (not the NHS suits/ministers decision). Then secondly they are given the correct training, financial incentive (in line of the doctors) then ultimately the back up they deserve. As Biccies as said the legal side is going to be intreging in this world of the No Win,No Claim vultures out there, nurses have a big enough role to play with out extra pressures.
 
#11
The_IRON said:
Theres been too many KILLER nurse stories in the press over the last few years and if this comes in could lead to more being put under increasing pressure. The only way this could work properly is first that the Senior Nurses are in the majority of wanting it (not the NHS suits/ministers decision). Then secondly they are given the correct training, financial incentive (in line of the doctors) then ultimately the back up they deserve. As Biccies as said the legal side is going to be intreging in this world of the No Win,No Claim vultures out there, nurses have a big enough role to play with out extra pressures.
Surely they would anyway, and would not be all they needed? I don't it's going to be your average inexperienced/Ward nurse doing this.

T C
 
#12
Nurses shouldn't have to make this descision. End of.

They should be concentrating on looking after their patients to the best of their ability, and putting them at ease. Not eyeing the bed up for it's next customer.

If a patient has asked not to be resussed, or has nominated a person to make this descision, their request can be placed on the notes by a doctor.

Nurses are to close to the patients, or should be, to make these choices.
 
#13
The_Cheat said:
Surely they would anyway, and would not be all they needed? I don't it's going to be your average inexperienced/Ward nurse doing this.
It will be. We have so many inexperienced nurses working as ward sisters now because all the more experience have been turned into management or practitioners and don't work the wards.
 
#14
chocolate_frog said:
Nurses shouldn't have to make this descision. End of.

They should be concentrating on looking after their patients to the best of their ability, and putting them at ease. Not eyeing the bed up for it's next customer.

If a patient has asked not to be resussed, or has nominated a person to make this descision, their request can be placed on the notes by a doctor.

Nurses are to close to the patients, or should be, to make these choices.
That is the HCA's job I'm afraid.
 
B

Biscuits_AB

Guest
#15
The_IRON said:
Biscuits_AB said:
amazing__lobster said:
Indeed - I'm pretty much on the fence at the moment.

Surely the nurses work too closely with the patients to make decisions like this? As in, if a nurse is working closely alongside a patient she does not like, it would probably be difficult for her to seperate that from making a professional decision?

Also, I know the standard of doctors varies, but I've met some nurses who probably wouldn't even be able to finish a degree in media studies - so not sure they should be allowed this amount of power.
Let's see (if indeed this is true) how this stands legally. Will a nurse be deemed to have the education and experience by which to determine life or death?
Theres been too many KILLER nurse stories in the press over the last few years and if this comes in could lead to more being put under increasing pressure. The only way this could work properly is first that the Senior Nurses are in the majority of wanting it (not the NHS suits/ministers decision). Then secondly they are given the correct training, financial incentive (in line of the doctors) then ultimately the back up they deserve. As Biccies as said the legal side is going to be intreging in this world of the No Win,No Claim vultures out there, nurses have a big enough role to play with out extra pressures.
Hey, go easy with the 'no win, no claim' vultures comment. If this malarky kicks off, I've just seen what's paying for my first Ferrari.

Ambulance chasing? Where's my trainers?
 
#16
They kill enough patients with simple, sloppy, clinical practice. (Hand washing...)

This can only enhance their value in their own eyes and take them further away from the actual job they should be doing which is wiping arrses in a correct and timely manner
_________________

Yaaaaaaaaaaaaaaaaaaaaaawn. When was the last time you washed your hands before visiting a ward. Visitors sitting on beds bringing bacteria onto the ward is as dangerous as not hand washing. Nursing is that easy & attractive that we don't have to import nurses. I can & do wipe arses but i'm trained to do other stuff as well. I'm not a fecking handmaiden
 
#17
The_IRON said:
Then secondly they are given the correct training, financial incentive (in line of the doctors)
So you mean make the nurses into doctors then? Nope, sorry, doesn't wash.

Nurses don't have the level of clinical responsibility that comes with a doctor's training - the buck stops with them, which is why they have the right to make these decisions. Nurses shouldn't be paid as much as doctors because their training and responsibilities fall short. Why can't they concentrate (as one previous poster put it) on wiping arrses, making patients comfortable, taking observations and dishing out medications (which they themselves are not allowed to prescribe...doctors have to do that.)

Actually, that's a good point. Nursey, who is now allowed to give you a DNAR, isn't allowed to write you up for an anti-emetic.
 
#18
sampaul1966 said:
Yaaaaaaaaaaaaaaaaaaaaaawn. When was the last time you washed your hands before visiting a ward. Visitors sitting on beds bringing bacteria onto the ward is as dangerous as not hand washing. Nursing is that easy & attractive that we don't have to import nurses. I can & do wipe arses but i'm trained to do other stuff as well. I'm not a fecking handmaiden
Friday afternoon...and between every patient too. If that's not your practice too I'd think that you really ought to look at your own standards before criticising visitors.

Oh and whose responsibility is it to ensure that visitors to the ward comply with infection control measures? Oh, right, the nursing staff. Get a fecking grip of yourself.
 
#19
Carcass said:
The_IRON said:
Then secondly they are given the correct training, financial incentive (in line of the doctors)
So you mean make the nurses into doctors then? Nope, sorry, doesn't wash.

Nurses don't have the level of clinical responsibility that comes with a doctor's training - the buck stops with them, which is why they have the right to make these decisions. Nurses shouldn't be paid as much as doctors because their training and responsibilities fall short. Why can't they concentrate (as one previous poster put it) on wiping arrses, making patients comfortable, taking observations and dishing out medications (which they themselves are not allowed to prescribe...doctors have to do that.)

Actually, that's a good point. Nursey, who is now allowed to give you a DNAR, isn't allowed to write you up for an anti-emetic.
Thats my point though, there going to be expected to do a job well below their pay scale. If they are expected to do this job then they would need extra training in clinical and extra stress related problems and more money to do so or the likes of Biccies will be will be in his Ferrari by next Christmas, can i have a drive when you get it please.
 
#20
Biscuits_AB said:
Hey, go easy with the 'no win, no claim' vultures comment. If this malarky kicks off, I've just seen what's paying for my first Ferrari.

Ambulance chasing? Where's my trainers?
Wouldn't that be Private Ambulance chasing? And what would be the point of that? :p
 

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