Do not resuscitate: waiting for a “Blue Planet moment”
Last December, Blue Planet II’s final episode showed a clip about the plastic crisis. Life hasn’t been the same since. It felt like attitudes towards plastic changed overnight. My friends were quitting straws, coffee cups, even make up wipes. Laws changed. I couldn’t help but think of the people who had been campaigning about plastic for decades prior to this. If they’d known, I’m sure they would have teamed up with David Attenborough ages ago.
This got me to thinking — what might our ‘Blue Planet moment’ be?
Why this matters to me
As a palliative care nurse, conversations about resuscitation and treatment planning are fairly frequent. It’s not unusual for patients, carers and the public to almost be offended at the idea of having a do-not-attempt-cardio-pulmonary resuscitation order (DNACPR).
You have the right to choose
In UK hospitals, in the event of a cardiac arrest it is presumed that the patient will receive cardio-pulmonary resuscitation (CPR) unless it has been recognised that the procedure will not benefit the patient and a DNACPR has been discussed and agreed. It is a medical decision, based on an assessment of a person’s health. Patients also have the right to refuse CPR and can do so by talking to their doctor or completing an Advance Decision to Refuse Treatment (ADRT).
If only others could see through my eyes
I am 30 years old with no past medical history or any issues that I know about. I have an ADRT. I have one because I have “inside knowledge” from working in healthcare. I know, that if I were involved in a sudden accident that meant I ended up in intensive care with no meaningful chance of recovery, I would not want my life prolonged my machines. I want to die naturally when that time comes.
I genuinely feel that if the tabloid press spent a few weeks inside our hospitals, and saw the way that people die in intensive care or by receiving CPR when it was clearly not going to work, it would be a sensation — I can see the headlines now — “Hospitals torturing patients”.
The sad thing is, so many patients and carers demand this. Intensive care is valuable to so many but it is not where, or how, I would choose to die.
I want to hear the music of my life, not beeps.
Medicine should complement life, not be blamed in death
I dream of a day where people use the healthcare service mindfully with awareness and purpose. Through Western society, we humans enter the healthcare system, are processed through it then blame it when we die. We forget that it is possible for a human to be born and to die without ever seeing a doctor. Medicine should complement life. We appear to have lost life in medicine. Or at least life as I see it. Life to me is about quality.
A DNACPR isn’t appropriate for me right now, but one day it will be and I will feel protected by it.
I have cared for many people that had CPR when they shouldn’t have, and I will never forget them.
One that sticks in my mind is a lady that was referred to the palliative care team for pain, agitation and breathing problems after being “successfully” resuscitated. She lived for another 12 hours after her heart was restarted. She had advanced cancer but wasn’t known to the palliative care team previously because she had no problems or symptoms. Her family were distraught after watching what had happened.
It’s not like you see on TV
CPR doesn’t happen like it does on Holby City. In real life it is chaotic, it hurts, and if successful in getting the heart restarted, it often provides more symptoms and complications to a person’s otherwise peaceful dying.
CPR saves lives, but it is only likely to be successful if the heart is the first thing to go. Not the last. I agree that the general public should be educated to provide CPR in an emergency for people whose heart has stopped unexpectedly. But the information needs to be balanced and people need to understand that CPR is not a treatment to cure normal, peaceful dying.
What will it take to wake people up to this? DNACPR is about protecting and valuing people. It is not an insult. I wish more people knew this.
Has anyone got David Attenborough’s number?
To understand more about the benefits and possible disadvantages of different medical treatments just ask — you can talk to your GP, practice nurse or call Compassion in Dying on 0800 999 2434.