What makes you happy ?

Experienced nurses should have the authority to decide if patients should be resuscitated, according to new guidelines to health professionals. BBC

Economics. That is what triggered this. Not patient care, not experience, not patient knowledge, just economics. People are becoming more aware that Do Not Resuscitate orders exist. Gone are the days when all this was hush hush and terms like “No crash” “No 333″ “TLC (tender loving care) only” were used as professional jargon. And when people know of something they will rail against it at some point.

“So your father - who had had 9 heart attacks, had advanced chronic obstructive airways disease, had kidney cancer, cirrhosis of the liver, gangrene in both legs, probably brain damage and warts - had his last heart attack and died, and because he had a DNR you think that’s wrong and are going to sue this hospital?”
“Yes”
“Okay - suspend the nurse who made that order”

Suspending a Dr costs a lot of money. They need full pay, the hospital needs to pay over the odds for a replacement and it could drag on forever. Effect on patient care can be measured.
Suspending a nurse means they still need their wage, but compared to the Dr they are cheap. There are lots of nurses so effect on patient care is zero.
The British Medical Association will have instigated this and there are 2 important factors here:
- Dr’s are supremely protective of their little empires. So giving any territory away is serious.
- The BMA could not care less about their handmaidens.
The BMA know that Drs will get sued, know it will bring their profession into the headlines and know they do not want this to happen. So easiest thing to do is wash their hand of the whole affair and make sure their ties are straight for when they are interviewed .. “Oh no, I would have said he could recover, We can treat gangrene very well these days and 9 heart attacks? Well you have to ask if they were even giving him the medication we prescribed”

This role is a poisoned chalice.