Wednesday, 23 October 2019

De mortuis

. . . nil nisi bonum. I'm not about to slag off one of the administrators who died at his post at The Institute yesterday morning; although we had unfinished business. Word has it that he stood up from his desk, sat heavily back down and died - he was 62. We inhabit a society that finds such abrupt departures unacceptable, so several people who share his office did their best to help him and one of them called the Nurse and an ambulance. We have a Nurse on site during the working day because our community is nearly 10,000 strong and some of them feel not-so-strong periodically. When one of my students slopped concentrated sulphuric acid onto the bed of the fume hood in 2013, and another student rested her fore-arm in the puddle <ouchy!>, it was to the Nurse I sent the injured party with a pal for support if needed.

Yesterday, when the nurse arrived at the double, she started on the SOP [standard operating procedure] for such cases including cardio pulmonary resuscitation CPR. I've done that, or at least the ventilation part of it, with no prior training, back 40+ years ago when I worked as a hospital orderly. It didn't work out in 1978, despite the best resources [well maybe untrained self excluded from 'best resources' in that case] and it happening in a hospital ward. While the Nurse tried manually to force some sort of circulation to the brain, two ambulances arrived, and the paramedics took over. I happened to leave the building at the end of the day with one of the technicians who'd been much closer to the centre than me. I said "Well at least he went quick". He replied "Not really, they went at him, CPR, defibrillator, the works, for an hour. They have to do that . . . until someone tells them to stop". An hour is a long, long time anoxic to retain any sort of quality life if they did get his heart going again. Let's ask some questions:
  • Who is it who finally calls it futile and  . . . tells them to stop
  • Why is that the policy? 
  • Is that Institute policy; paramedic policy; Nurse policy?
  • Who benefits?
  • Is there any sense of informed consent about these procedures from The Principal ?
I think I've made my DNR or even my NFR instructions clear to my family. It's quite okay if they hold my hand [it might be reassuring] or just wring theirs without feeling obliged to Do Something. I have no intention of dying at work, but I will now have a word with my most immediate work-mates to call my family but not call an ambulance. I really cannot abide fuss.

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