Resuscitation discussions: learning from Covid‐19

• Published in: The Clinical Teacher Vol. 18; no. 3; pp. 206 - 207
• Main Author: Davies, Kristen
• Format: Journal Article Web Resource
• Language: English
• Published: England John Wiley & Sons, Inc 01.06.2021; John Wiley and Sons Inc
• Subjects: Insights
• ISSN: 1743-4971; 1743-498X
• DOI: 10.1111/tct.13278

Initiating DNACPR discussions is often found to be difficult for medical staff, with health professionals deterred by fear of causing distress, attracting complaints and time constraints.1 Additionally, in the UK, an evidence synthesis has found that there is variation in hospital implementation of national guidelines surrounding DNACPR decisions,2 further complicating matters. Furthermore, while junior doctors are expected to ‘contribute to the care of patients and their families at the end of life’,4 by the time they left medical school, most felt that their undergraduate preparation did not prepare them well enough for such discussions.3 An exploratory investigation into DNACPR decisions from 43 countries highlighted a common theme that the lack of teaching for end‐of‐life issues at medical school meant that doctors had not developed the communication skills necessary to discuss DNACPR decisions.5 In light of the current circumstances, training around treatment escalation and DNACPR discussions remains an unmet need for junior doctors and undergraduate medical students. [...]an integrative review into DNACPR conversations in the UK recommended the introduction of advanced communication skills training during medical school and extending this into specialist medical training.1 From my experience in A&E, I would strongly argue for the introduction of escalation and DNACPR discussions throughout medical training.