Quite important to always
Circle the form please
Contrary to the idea that life in the hospital must be preserved at all costs, most older patients who come into hospital are ‘not for resuscitation’, which means that if a cardiac arrest were to occur, doctors would not give CPR. This is ultimately a medically-informed decision made in agreement with the patient (if they are not competent, then the doctor has jurisdiction to make this decision for them). A bright A4 form should be filled out with this decision and placed at the front of each patient’s notes.
One of the problems with the form is that it’s a passive document that has no role until an arrest actually occurs at which point it’s too late to fill out. If the form goes unfilled, an arrest inevitably triggers a cascade of resuscitation interventions which are hard to stop. This can lead to unnecessary and resource-intensive procedures in the attempt to save life because a form wasn’t filled out.
Zoë recently got in touch with us because she noticed a lot of patients didn’t have their resuscitation status form filled in. Rather than send a growling email to her colleagues, she sent every doctor in the hospital the haiku above. She got a much better response than she would have otherwise.
Zoë Raos is a gastroenterologist and general physician at Waitemata DHB in Auckland and is of Te Ati Awa descent. She is involved with training, research, quality and service development and works in private practice too. She co-authored a popular study guide for medical registrars (‘How To Pass’) now in its second edition, as well several scientific papers. Zoë writes and illustrates lots of stories and books for her son – his autism means that written words provide an anchor to the here and now, as well as enabling freedom of expression and imagination. She lives in Auckland with her husband, son and daughter, and appreciates the irony that this bio contains about 12x the number of syllables as the haiku she has submitted to this journal.