“One of the most sincere forms of respect is actually listening to what another has to say”
(Bryant McGill: international bestselling author, activist, and social entrepreneur)
There has been a lot of discussion in the last few weeks about Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) especially with the publication of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) http://www.respectprocess.org.uk/
The British Medical Journal published a number of pieces which should be read. They are eloquent, elegant and engaging e.g.:
- Zoë Fritz and colleagues discussed in detail new approaches to resuscitation decisions that incorporate broader goals of care.
- David Pitcher et al reflected upon emergency care and resuscitation plans
- Kate Masters offered a personal view as a daughter on DNACPR
- David Oliver mused on why he is changing his mind about resuscitation
Elsewhere Radio Four discussed the ReSPECT documentation and DNACPR.
Responses to this and the BMJ articles promoted a variety of thoughts in the rapid response section.
There were also reflections on the work of engaging in DNACPR discussions as well as stories of escalation creep and different ways to frame DNACPR . Other reactions included what did CPR achieve as well as observations on a focus on only one intervention (DNACPR) without taking into account wider priorities
So why does this all matter? Is this just empty chatter in the health care social media echo chamber or an attempt to tame death through medicalisation, protocol and institutionalisation?
As this week draws to a close, I have been reflecting upon words generously shared with me in the past; a research participant discussing what influenced her in her advance care planning.
“It’s like…like when I was making a dress for someone they would bring me their pattern and I would measure them and ask them what the dress was for and and when it was finished it was tailored…tailored for them…someone else might have that pattern but no one had that dress…do you see? So when you talk to me about this ask me…ask me…measure me up…do you see?”
These words reminded me this week to remember to respect the diversity of views, opinions and experiences of my colleagues and fellow human beings. To listen to what people were actually saying and think about what that meant to me as a nurse, patient or carer.
Conversations and considerations about dying, advance care planning and DNACPR will always hold different resonance for us all, but
Patience matters. Diversity matters. Listening matters. Respect matters.
“We all should know that diversity makes for a rich tapestry, and we must understand that all the threads of the tapestry are equal in value no matter what their colour.” (Maya Angelou – American poet and author)
For more information and resources about the ReSPECT form see http://www.respectprocess.org.uk/
Sarah Russell is a hospice nurse with an interest in advance care planning.