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Dads final days spent in hospital

Posted By Doveoverskye

"Dads final days spent in hospital"

About: Forth Valley Royal Hospital / Clinical assessment unit Forth Valley Royal Hospital / Elderly medicine

(as a relative),

Good care more or less under obvious shortage of all staff in CAU & ward A12.

Dad's health not been great for a few years he was 81 & had many health problems. In his last week he had developed a chest infection & after antibiotics from GP didn’t work he was admitted to CAU. During the junior Doctors' assessment the question of DNR was brought up & dad got agitated & felt he was being told he wouldn’t get ANY treatment. A short time after, a senior Doctor came to see dad & he also talked about DNR this time his gentle way meant dad agreed no DNR. Mum & I were then talked to & mum explained as dad had an aneurism in his stomach none of us expected resuscitation.

Dad was transferred to A12 & the Doctor came to speak to the family & unbelievably again we went through the same conversation about DNR & again the Doctor spoke to my dad about it! This was too much & very upsetting at a very bad time.

We 100% know it is important in every way to get the patient & family to give their wish but not like this, surely a coloured wrist band (yellow, green etc) could be put on patient to say DNR or even flag it has been asked about.  

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Responses

Response from Patrick Rafferty, Head of Nursing, Ambulatory & Investigations, NHS Forth Valley 4 years ago
Patrick Rafferty
Head of Nursing, Ambulatory & Investigations,
NHS Forth Valley

Submitted on 09/05/2019 at 09:06
Published on Care Opinion at 09:31

Dear Doveoverskye,

Thank you for getting in touch during such a difficult time for you and your family.

Please accept my apologies for the distress you describe. The conversation regarding DNACPR is, as you rightly say, an important one, but it is also one which is very difficult for patients and their families. I’m very sorry that in this incidence we have repeated this conversation and caused additional distress, this is not what we would aim to do.

The Clinical Leads for Palliative and End of Life Care are also aware of your feedback, and we intend to discuss this further to see what learning can be taken to help ensure this doesn’t happen again.

If you would like to discuss this further, or anything else, please feel free to get back in touch at any time. I can be contacted via the Patient Relations Team on 01324-566523

Kind regards,

Patrick

Patrick Rafferty

Head of Nursing

Medical Directorate

NHS Forth Valley

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Update posted by Doveoverskye (a relative)

Thankyou Patrick Rafferty for the response you gave to Dads story. What you have said is exactly the reason I wanted to tell the story & just what I hoped would happen. To talk about the procedures and care and see if anything can be done differently or improved is perfect.

Thankyou and Thankyou all at FVRH for all the times you cared for dad over many years.

Response from Pauline Donnelly, Person Centred Manager, Department of Nursing, NHS Forth Valley 4 years ago
We are preparing to make a change
Pauline Donnelly
Person Centred Manager, Department of Nursing,
NHS Forth Valley

Submitted on 16/05/2019 at 11:15
Published on Care Opinion at 11:27

picture of Pauline Donnelly

Dear Doveoverskye

Thank you for taking the time to share your feedback at this really difficult time.

I was really saddened to hear of your experience at a really important time in your dad's care. I am really sorry that both your dad, you and the family were caused distress by the repeated conversations about DNACPR (Do Not Attempt Cardiopulmonary Resuscitation).

Clinicians do have a duty of care to discuss CPR decisions, as you rightly acknowledge, and this should be communicated sensitively and at the right time. These necessary but difficult conversations should ideally take place with a health care professional that someone knows. However, sometimes they have to take place with someone they have just met or in a busy environment due to a sudden deterioration in health and this is less than ideal for such a sensitive discussion.

Once a DNACPR decision has been discussed, this should then be recorded using a standard document which is filed at the front of the clinical paper record, added as an alert on the electronic record and this should have been clear to the staff involved in your dad's care.

On behalf of the hospital palliative team, I would like to assure you that we use all feedback, to shape and improve patient care and the experience of patients and their families. We are currently making significant changes within the organisation around DNACPR documentation and looking at better ways of communicating and documenting these decisions with the use of the ReSPECT process (www.respectprocess.org.uk), an emergency treatment plan. This will be better for patients and their families, is much more person centred and considers CPR decisions as part of an overall treatment plan, this is a much gentler approach. Meanwhile, we will continue to support and provide essential communication skills training for clinicians at all levels, for these sensitive discussions, recognising that these difficult discussions can still sometimes cause discomfort and distress.

If there is anything further I can do or if you need any further information please do not hesitate to get in touch.

Dr LA Fielden

Consultant in Older Peoples Care

Hospital Palliative Lead

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