Hospitals in chaos - staff, money, extra Covid ward

I’m sorry about all this Nashville. I can only say that it is allowed for medics to put a DNR in place on a patient if the medics think that it is necessary. A DNR was put in place on my elderly mother, aged 93, when she was in hospital. At first she wouldn’t agree, but eventually she agreed. Resuscitation in very poorly or elderly patients is not a very pleasant process. Their ribs can be broken and they are not guaranteed to recover properly. They can survive with either brain or other organ damage.

I feel uncomfortable about people being pressurised to sign DNR forms. I do recognise that the procedure and quality of life of the patient may make it advisable but shouldn't the possible outcomes be gently explained to the patient rather than a patient being bullied?

What happened when the 73 year old reported to the assessment unit the next morning Nashville, were they admitted to a bed? I wondered because most patients with blood clots aren’t admitted to hospital these days, they are given medication and are treated at home.

First of all, I'm so sorry that you have two family members who are so poorly. TBH with a terminally ill patient I think it's family who should discuss DNR with their loved one, it's often so much kinder to the patient not to resuscitate when they are coming to the end of their life. OH and I have already discussed this and our daughter knows what we would wish if we were unable to make that decision for ourselves. Sadly there is huge pressure on beds in most hospitals ATM and they can only admit those with the greatest need, I'd try to take some comfort from the fact he was triaged as a category 6 rather than a 4. I hope he makes a full recovery.

Around twenty years ago a friend of mine was found to have not one but several clots in her lungs. She was not admitted to hospital, but medicated and remained at home. She is still alive and well today. I had to sign a DNR for my husband when he was suffering from young onset dementia. It is an emotionally painful thing to do, but should he have gone into cardiac arrest, I would not have wished him to be put through CPR.

It's a bit tongue in cheek that NHS staff have DNR tattooed on their chests!
But it's not nice to witness (I have seen several times in my career) only about 7% are successful.
If patients have capacity they are asked directly and this can be retracted if needed , but if they are so poorly it will not make any difference to any outcome and family won't agree to a DNR, the Doctor can recommended the DNR as best interest.

Casdon the 73 year old was admitted the next day at 8 pm, after 11 hours on a chair in the assessment unit, onto an a acute medical ward. He was kept in overnight and discharged at 7 pm the next day having waited for the pharmacy to deliver his increased dose o waferin injections for 7 hours. He is to report to the anti coagulation clinic on Monday at 9 am. He is to phone his kidney specialist to see if his recent change of medication could have the side effect of clotting and tell the anti coagulation unit his findings. The 76 year old was discharged as his infection abated. He was handed a respect form at point of discharge as a final push on the dnr. Cannot work out why as its imposition has been decided by the doctor. He does not wish to go back to the hospital ever again and hopes to die without to much pain at home having felt bullied throughout his 5 day stay and has no wish to meet with those doctors ever again. All very sad.

'take one for the team' That is no way to talk to people. Can you access any hospice care/outreach for them?

Was the 72yo given blood thinners?

Sorry it took me so long to post, you'd already posted.

Take one for the team. If that was said it should be reported to PALS as it crossed the line to bullying and harassment.

Nashville, it would have saved a lot of anxiety for your 73 year old relative if they had not been kept so long on the Assessment Unit on two occasions on consecutive days, there must have been a shortage of beds because it’s lot more inefficient for the system as well as awful for the patient - normally if somebody is sent home overnight they just need a check up the next morning and are discharged but that obviously didn’t happen. I hope treatment goes smoothly from now on.

I hope your other relative has a palliative care nurse allocated, and they are visiting/in touch regularly, as it sounds like some professional nursing support and advice at home is going to be what they need. It’s a very tough time for you all, you have my sympathy.