Hola a tod@s, my dear friends.
From the blue of the sea and holiday rest, Dr. Alfredo Serrano (@alfchus) send us a very interesting article, which talks about communication between hospital doctors and patients in cardiopulmonary resuscitation.
In theory, from Bioethics and papers, is recommended to establish concrete plans of action and discuss with the patient the realization of cardiopulmonary resuscitation maneuvers if necessary, to promote his/her own autonomy, knowing their wishes.
Doctors should make sure that patients understand their prognosis and we should plan treatment objectives jointly. But studies in the past 20 years suggest that there is a way from theory to practice, and these recommendations are not followed.
Doctors do not know about the preferences of patients and in many cases we have to act and decide when the patient has no voice. And there are still many hospitals where we don’t have recorded in medical history relevant orders in patients at risk for cardiac arrest.
In this research recordings were carried out on doctor-patient encounters (80 patients with 27 doctors) and an analysis of content was conducted.
Only 11 doctors spoke of the situation “At heart failure… What do you want us to do?” with 19 patients, mainly in those more critically ill. And they employed exactly a minute on average (between 20 seconds and 8.2 minutes). Only one spoke about the prognosis.
The talks focused more on technical aspects on life support and medical jargon. It is very difficult to talk about death with patients, and we know it.
The authors conclude that simply, the indication of CPR was not discussed with patients. We don’t do a good job in discussions about end of life support. Brutal honesty.
And how we can improve this situation?
Certainly communication skills seem to be a necessity.
Should we go from theory to practice?