The Archie Battersbee case

[cantthinkofaname2]

This sounds awful, but I’m ‘glad’ the DNAR has been put in place today rather than waiting until Friday at the judgment hearing. If Archie decides to go, he goes peacefully and without the brutality of CPR which would no doubt be pointless anyway.

 

[Purrrrrrr]

Didn't someone here post that Hollie had put a DNR on the door. Might have been a photo?

 

[Weeder]

Barts Health NHS Trust v Dance & Ors (Re Archie Battersbee) [2022] EWCA Civ 935 (06 July 2022)

Here is the link for when Archie’s parents won their right to appeal in late June

I've read it. For me I still think she's an evil bleep. I understand due process and that the courts obviously need to be looking at this sort of thing, but as I said, she has no interest in this, it's just a means to an end for Hollie, who wants to win regardless of the prize.

 

[MidnightAura]

Didn't someone here post that Hollie had put a DNR on the door. Might have been a photo?

She wrote he was to be resuscitated I think. Alongside a “Please talk to Archie when you work with him and introduce yourself to family“

This poor child is never going to know peace.

 

[nini01]

Didn't someone here post that Hollie had put a DNR on the door. Might have been a photo?

She wrote in his board NO DNR

 

[Merpedy]

I don't really understand what a 'natural' death would then be without a DNAR in place tbh. Either way the result is the same, just one of them isn't as stressful as you don't have a whole team of people around trying to resuscitate

It seems like a miracle that he has only had two 'scares' of cardiac arrest to begin with tbh

I have sort of been on her wavelength with other decisions and things she has been saying but this one I just don't understand at all

 

[cantthinkofaname2]

I don't really understand what a 'natural' death would then be without a DNAR in place tbh. Either way the result is the same, just one of them isn't as stressful as you don't have a whole team of people around trying to resuscitate

It seems like a miracle that he has only had two 'scared' of cardiac arrest to begin with tbh

I have sort of been on her wavelength with other decisions and things she has been saying but this one I just don't understand at all

I can only think it stems from a ‘we did everything we could to save him’ mentality. If resuscitation was tried, but failed, they can ultimately say at least we gave it a go

 

[Purrrrrrr]

She wrote in his board NO DNR

Ahh Right.

 

[Mollywobbles]

She wrote he was to be resuscitated I think. Alongside a “Please talk to Archie when you work with him and introduce yourself to family“

This poor child is never going to know peace.

When my mum was in ITU the nurses and doctors spoke to her all the time and explained when they were going to change a bag, etc even though she was in an induced coma.
It seemed to be standard practice, partly for the patient but also for the family.
There is no need for her to tell the hospital staff to do that. They are kind and caring and that kind of instruction is downright nasty!

 

[MidnightAura]

When my mum was in ITU the nurses and doctors spoke to her all the time and explained when they were going to change a bag, etc even though she was in an induced coma.
It seemed to be standard practice, partly for the patient but also for the family.
There is no need for her to tell the hospital staff to do that. They are kind and caring and that kind of instruction is downright nasty!

It is i agree. When my grandparents received end of life treatment the nurses always spoke to them when doing anything with them. Particularly when we weren’t sure they could hear them. I don’t believe any Of the staff working with him would go in and do what they need to in silence. Considering Hollie admits to filming staff and she has a record for attacking someone I pity the staff. It can’t be easy for them.

 

[super grateful]

The projection of care should be, in my opinion, withdrawal of life sustaining treatment which would look like: removing all unnecessary lines and monitoring, stopping feeds (no idea why they are on), stopping fluid and vasopressors/inotropes, which will decrease BP/HR, stopping all medications (IV and enteral) and then taking the ETT (breathing tube) away. He is brain stem dead so unable to breathe for himself, so they may decide to stop the blood pressure increasing medications shortly after they take the breathing tube away, so that he doesn’t “die” as soon as they take the breathing tube away whilst the family aren’t immediately within reach as that isn’t a very nice memory for them. If someone isn’t already brain stem dead, some symptom control drugs might be started if required, but in this case I doubt they would be needed. But I don’t imagine this scenario happening, I think sadly he will deteriorate and deteriorate on the ventilator and die on the ventilator which should never happen as it’s just horrific, messy, undignified, uncontrolled and can be totally avoided. There is the chance for this to be so planned and turned into as nice a memory as it possibly can be.

 

[cantthinkofaname2]

The projection of care should be, in my opinion, withdrawal of life sustaining treatment which would look like: removing all unnecessary lines and monitoring, stopping feeds (no idea why they are on), stopping fluid and vasopressors/inotropes, which will decrease BP/HR, stopping all medications (IV and enteral) and then taking the ETT (breathing tube) away. He is brain stem dead so unable to breathe for himself, so they may decide to stop the blood pressure increasing medications shortly after they take the breathing tube away, so that he doesn’t “die” as soon as they take the breathing tube away whilst the family aren’t immediately within reach as that isn’t a very nice memory for them. If someone isn’t already brain stem dead, some symptom control drugs might be started if required, but in this case I doubt they would be needed. But I don’t imagine this scenario happening, I think sadly he will deteriorate and deteriorate on the ventilator and die on the ventilator which should never happen as it’s just horrific, messy, undignified, uncontrolled and can be totally avoided. There is the chance for this to be so planned and turned into as nice a memory as it possibly can be.

Sorry for asking this, but intensive care medicine fascinates me, when of course it’s used for the correct purpose and it’s sadly been apparent for a while in Archie’s case that it’s not….. Would you say with the judge agreeing to the DNAR that it’s likely to be needed? So in which case the final judgment on Friday won’t be necessary?

This is an intriguing post…. Why the sudden change of heart on the hearings being made public?

 

[Satisfying Click]

I think the purpose of the judge putting the DNACPR in place was to reinforce the fact that relatives cannot demand CPR as a treatment (doctors cannot be compelled to offer treatment they consider futile or inappropriate), it takes a bit of pressure off the staff in ITU to continue with futile discussions behind the scenes (I'm assuming).

 

[MidnightAura]

Sorry for asking this, but intensive care medicine fascinates me, when of course it’s used for the correct purpose and it’s sadly been apparent for a while in Archie’s case that it’s not….. Would you say with the judge agreeing to the DNAR that it’s likely to be needed? So in which case the final judgment on Friday won’t be necessary?

This is an intriguing post…. Why the sudden change of heart on the hearings being made public?

I would like to think this is because they are aware that the remaining time with Archie is private and shouldn’t be on display for the vultures I mean army to talk about. But the cynic in me thinks it’s so Hollie can say whatever she wants To the army.

 

[Cack Conroe]

I disagree that people hero worship NHS staff (as an NHS staff who has experienced quite the opposite) and I do agree that medical professionals do make mistakes, as do engineers and postmen and drivers, etc. I however have never personally experienced cover ups and find, from seeing colleagues go through trials, that my regulatory body, the NMC, are quite harsh and strict (as they should be) when it comes to disciplinary action, unlike some others. But that’s just my experience.

Also regarding staff not coping and “being in the wrong job”, I feel a little personally insulted by this but hey, whatever. I deal with some really sad tit almost every shift, as it’s just the nature of the place I work. Sometimes I can deal with and empathise the situations well and then one day it all just gets a little much and I become a bit invested, or a patient / family dynamic / mechanism of injury reminds me of my own life and things just get to me. I might cry when a family member hugs me, I might sit out of one of the family chats and let a colleague do it whilst I compose myself, I might need a hug in the linen cupboard, but it doesn’t affect the care I give to that family and actually I think it enhances it - it means I am human and that I care. I have had many families say to me “we saw you wipe your tears when we said our goodbyes, thank you so much for caring for Mum like she was your own” etc etc. Being able to care for a patient and see them as a person aids your decision making and ensures you are seeing them for who they are, not just a job to do. It’s not just go in, put the drugs up, do what needs doing and go home. It’s are these drugs and interventions relevant, does this brain dead child need these? Are they helping him or are we torturing his body and his family?

I’ve lost my point. But basically it’s okay to care. It’s not “not coping”. And I hope those nurses, as all healthcare professionals should, have access to TRIM practitioners.

It's fine to care but it's not acceptable for the emotional needs of staff to be centered. They should not have a stake in this and I find it ridiculous that their "distress" from doing their job should be given any credence at all. These people see horrific injuries and tremendous pain on a regular basis and we are supposed to believe that caring for Archie - who is universally agreed to not be suffering - is somehow emotionally damaging them, to the point their precious feelings should be considered in court.

 

[GalaxyGirl70]

I think they wanted it to be private so she didn't have to defend any potential change of heart to the barmy army.......

 

[Merpedy]

I think the purpose of the judge putting the DNACPR in place was to reinforce the fact that relatives cannot demand CPR as a treatment (doctors cannot be compelled to offer treatment they consider futile or inappropriate), it takes a bit of pressure off the staff in ITU to continue with futile discussions behind the scenes (I'm assuming).

I think it's also giving them time to emotionally prepare to say goodbye tbh. Given the conversations happening in court it very much sounds like the judge isn't going to side with whatever the family's plan is

I think they wanted it to be private so she didn't have to defend any potential change of heart to the barmy army.......

I think so too tbh. It was a bit concerning earlier when they started talking about how Hollie should try and sue one of the reporters who was summarising what was happening on Twitter. That reporter never came back after the lunch break which I found a bit odd

 

[cantthinkofaname2]

I would like to think this is because they are aware that the remaining time with Archie is private and shouldn’t be on display for the vultures I mean army to talk about. But the cynic in me thinks it’s so Hollie can say whatever she wants To the army.

I think so too she’s suspiciously quiet on the army page. All asking for updates but there’s nothing

 

[Merpedy]

Sorry to be back with the continued DNAR confusion discussion but:

The parent's plan entails DNAR and limitation of treatment orders, yet continuing mechanical ventilation and nutrition /hydration. Such a plan, the Trust explains, results in a death that is more unpredictable, meaning that neither the staff nor family could be ready. The Guardian supports the Trust's position.

https://medicalfutility.blogspot.com/2022/07/archie-battersbee-court-hearing-to.html

So why is she upset with the DNAR order placed today? DFA are saying that Hollie was making it out that the hospital was forcing her to put one in place but the guy who wrote it but the article is written by a law professor and I doubt that he has somehow misunderstood what the family's wishes were

 

[ChastityDingle]

I hope that he soon is allowed to go peacefully.
It's unimaginable really. The poor little fellow.