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michael stone

michael stone

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Comments (2690)

  • Comment on: 'Initial NHS contact can affect patients’ opinions of nurses'

    michael stone's comment 27-Aug-2014 10:33 am

    I'm 100% with Mark, re his: '“That’s not what I asked,” I said.' It is remarkable, how often the answer (assuming you actually get one) 'from the NHS', falls into the 'that isn't an answer, to the question I asked' category.

  • Comment on: CNO to review form after concerns raised over DNR question

    michael stone's comment 26-Aug-2014 3:08 pm

    I've noticed a tendency for me to type 'their' instead of 'there' recently: this worries me. But I'm afraid this isn't solely about not attempting clinically pointless CPR. It is actually, about letting patients make their own choices about [uncertain] futures. Do patients change their views, as their situations change ? Yes. Do some 'terminal' patients actually recover ? Yes. But it isn't about those uncertainties - it is about patients making their own choices, after the clinical uncertainties have been explained to them. And, yes, not explaining to relatives, that 'your dad is so frail, that he will now die whatever we do' is an area fraught with problems. So is the possible 'rapid clinical deterioration of the elderly', which if NOT PROPERLY EXPLAINED to relatives, can [easily] lead to 'suspicions of murder': http://www.dignityincare.org.uk/Discuss_and_debate/Discussion_forum/?obj=viewThread&threadID=721&forumID=45

  • Comment on: CNO to review form after concerns raised over DNR question

    michael stone's comment 26-Aug-2014 10:36 am

    Anonymous | 26-Aug-2014 8:44 am A lot in their I agree with - although 'next of kin' isn't the same thing as 'those close to the patient', and there isn't auromatically a role for 'next-of-kin' in this EoL stuff. There are many issues - but turning 'objectives' into 'tick-box' is one of the major problems.

  • Comment on: Hermione Elliott: 'Death doulas complement nursing care at the end of life'

    michael stone's comment 23-Aug-2014 2:29 pm

    I'm sure that this 'death doulas' thing has value. But personally, I think I would prefer to be certain of who assesses my pain and its relief - is that me, or someone else who isn't actually directly experiencing my pain ?: http://www.dignityincare.org.uk/Discuss_and_debate/Discussion_forum/?obj=viewThread&threadID=680&forumID=45

  • Comment on: CNO to review form after concerns raised over DNR question

    michael stone's comment 23-Aug-2014 2:24 pm

    The whole area of 'talking about dying' and the associated 'planning for death' is fraught, confused and not joined up - it needs a lot of work (as, even more so, does thrashing out the law around dying, and post-mortem behaviour for home EoL deaths). http://www.bmj.com/content/347/bmj.f4085/rr/652862 http://www.bmj.com/content/347/bmj.f4085/rr/654490 http://www.bmj.com/content/348/bmj.g2043/rr/700882 and several others on the BMJ, intended to promote 'more thinking' about these issues. For example, section 3 of the Mental Capacity Act, does not describe how mental capacity is assessed: http://www.bmj.com/content/349/bmj.g4349/rr/760472 And 'shared decision-making' is a truly strange term: http://www.bmj.com/content/349/bmj.g4855/rr/761712 But just for once, the Mail might have got this one right: while patients need to express wishes about CPR early enough for their to be a point to that, nobody should 'suddenly drop the question on them' without a very good reason to do that. Although sorting that one out, seems to me to be one of the simpler EoL issues to address: if it has been happening, I suppose it is the result of some absurd bit of 'box ticking' coming from somewhere [in 'the system'].

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