Assisted Death

[Acrylic-bob]

Which would be all very well, Margaret, if the NHS was just starting out. You could easily make allowances for the uncoordinated responses and lapses in care, respect, and humanity. But the NHS is not a recent invention. It has been lurching from crisis to crisis for seventy years, longer than I have been alive! How much more of this institutionalised incompetence do we have to take before we wake up and admit that it does not work and a new approach is needed?

[Acrylic-bob]

Originally Posted by Margaret Pilkington

Sometimes the doctors will speak with relatives of seriously ill patients who are not expected to survive and will mark the notes DNR(do not resuscitate)

Which supposes that there are, more commonly, instances where doctors do not speak to relatives of the terminally ill and routinely mark the the notes DNR anyway.

[Margaret Pilkington]

I wish I had the answer for you.
All I can say is that I know how things should be done.
That can be a bind, because you have expectations....and frequently the service will not match your expectations.....and this is true even if you are paying privately.
I know of an old lady(in her 90's) she has no family in this country. She is well off and pays for her care.......and it is abysmal.
The young girls who come to deal with her personal needs do not speak english, or have only a very basic understanding.......they rush in and just do the minimum to tick the boxes on her care plan.
This lady lives in Eastbourne.......if she lived nearerI would undertake some of her care myself(well, I would if she would let me - she is an old friend of my mothers and frequently says she wishes I lived down there and would help her the way I help Ma).

[Margaret Pilkington]

Originally Posted by Acrylic-bob

Which supposes that there are, more commonly, instances where doctors do not speak to relatives of the terminally ill and routinely mark the the notes DNR anyway.

Well, I obviously cannot speak for what happens now, but it was not allowed when I was in charge of the ward. Notes marked withDNR had(it was policy) to have the consent of the consultant, who would first meet with relatives before marking the notes thus.

As I said in my previous post the problems arose when such patients who were terminally ill - end stage terminal, arrested and there was no order not to resuscititate...this meant resuscititation had to be attempted.

[mobertol]

Originally Posted by Margaret Pilkington

A 'living will' would or should have prevented that.....she would have not have been intubated and would have been allowed to succumb.
I don't know if you have the equivalent of living wills in Italy.

Sometimes the doctors will speak with relatives of seriously ill patients who are not expected to survive and will mark the notes DNR(do not resuscitate) but my own experience of this, is that the consultants that I worked with were very reluctant to mark this in the case notes...regardless of how hopeless the case was....and in the absence of such a record, it meant that if the patient arrested we had to attempt resuscitation. This is not good when you have a patient in the terminal stages of cancer.......all you are doing is prolonging their suffering and pain.

This was 6 yrs ago Margaret, so living wills were not common. Also the doctors convinced my sister-in-law to continue the treatment, giving the impression that there could be some hope when effectively there was not.

By contrast we looked after my Father-in-law through lung cancer at home in 2001 and he had a much better "end", with good pain control and assistence once we had managed to get it in place..i think most patients would rather not be in hospital when they know they are terminal.

[Margaret Pilkington]

To be honest hopsital is not the right place for end stage terminal care.
Patients are much better in their own homes with the right suppost services in place...but that is the key.......right support services and the support must be aimed at the family as well as the patient.

[Acrylic-bob]

Originally Posted by Margaret Pilkington

I wish I had the answer for you.
All I can say is that I know how things should be done.

I was reading an article on care at the end of life the other day and it shocked me to discover that the one thing the elderly fear most is not dying, but going into hospital. I am talking here of people over retirement age.

That is so, so, wrong!


Personally I blame television series like Holby City. They are dramas and they naturally present life in a hospital as edgy, exciting and mawkishly sentimental all wrapped up in youthful idealism with 'attitude'. We are all depressingly aware that the younger generation have a difficulty separating fact from fiction. It is hardly surprising therefore that the idea of nursing as a vocation has gone out of the window and that for this celebrity obsessed generation the idea of doing anything that involves contact with bodily fluids or bodily waste is beneath them and that consequently they regard those who produce such things as equally beneath them. Sadly, from there it is but the very shortest of steps to considering such people as less than human and, quite frankly, a nuisance, really.

[Margaret Pilkington]

It as watching Emergency Ward 10 that made me want to become a nurse....but that was way back when TV was somehow gentler.
I agree that people don't seem to want to go into nursing....as you say the young folk(or at least some of them) are much more interested in getting celebrity status.
The people who do choose to go into nursing sometimes do it for the wrong reasons...but that isn't their fault, it is the selectors failure to recognise this.

I loved my nursing career. It was like being paid for something I enjoyed...yes, it was hard work, yes there were days when I came home and wondered what the heck I had let myself in for.....but it was the most satisfying job ever....but again, it was spoiled by making it university based. Caring is something that does not need a university education. It takes common sense and application, it takes kindness and compassion...show me a university that can teach these things.

[jaysay]

Originally Posted by MargaretR

If you think that your governments care about individuals - think again.
There is a policy in operation to reduce world population.

If you happen to be a 'useless eater' beware.
Laws to make suicide easier will happen, but will be restricted to non productive members of society. There will be the added bonus of benefit and NHS savings.

The law is more preferable (to governments) than the expensive alternative of providing effective pain relief and palliative care, which are rarely provided.

So you think you are being given a choice? - it is Hobsons choice!

The world according to Zog, I'm certainly glad I don't exist in it.

[jaysay]

Originally Posted by Acrylic-bob

Which would be all very well, Margaret, if the NHS was just starting out. You could easily make allowances for the uncoordinated responses and lapses in care, respect, and humanity. But the NHS is not a recent invention. It has been lurching from crisis to crisis for seventy years, longer than I have been alive! How much more of this institutionalised incompetence do we have to take before we wake up and admit that it does not work and a new approach is needed?

I was sorry to read your terrible experience that became some one close to you Bob, but as somebody who has spent more than there fair share on wards in six hospitals over the past 30 years, I only have praise for the doctors nurses and related professions, without whom I wouldn't be here today, I have never had any cause to complain, except about the food in my first ever stay in hospital Bury General, apart from that I feel very humble and indebted to those wonderful people for the first class care I've received. The only complaint I've ever had is with the administration side of NHS, which really does leave a lot to be desiredand is certainly top heavy

[mobertol]

[quote=Margaret Pilkington;960663]It ws watching Emergency Ward 10 that made me want to become a nurse....but that was way back when TV was somehow gentler.
quote]

The one we used to watch avidly in the mid 70's was " Angels" -do you remember that one Margaret. It was quite unromantic and not a bit like E.R. or the all-action series that have followed.

[Margaret Pilkington]

yes I do remember that. I was a student nurse at the time and the writer of the series came to interview me for ideas for the story lines.

[mobertol]

Originally Posted by Margaret Pilkington

yes I do remember that. I was a student nurse at the time and the writer of the series came to interview me for ideas for the story lines.

Who were you then? The glam Fiona Fullerton!

[susie123]

Originally Posted by Margaret Pilkington

It as watching Emergency Ward 10 that made me want to become a nurse....but that was way back when TV was somehow gentler.

Ah those were the days... Nurse Carole Young... Did you know they have brought out some episodes on DVD?

Totally agree about the foolishness of requiring degrees for nursing.

[Michael1954]

Originally Posted by claytonx

My opinion is that I do not agree with assisted death.
There again it could change with a deterioration in health.
You have heard people say that it was a blessing in disguise, when the event happens in some cases.

In other words: no, yes, maybe!