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CPR decisions: we support best practice guidance, insists NMC chief executive

Nurse regulator’s Andrea Sutcliffe enters debate about its suspension of nurse who did not attempt CPR
clinical staff attempt CPR

Nurse regulators Andrea Sutcliffe enters debate about its suspension of nurse who did not attempt CPR

The head of the Nursing and Midwifery Council (NMC) has moved to clarify in her own words the regulators position on when it expects registrants to perform cardiopulmonary resuscitation (CPR).

Andrea Sutcliffe's blog post comes after a recent high-profile fitness to practise ruling in which experienced nurse Nahid Nasiri was suspended from the register after failing to attempt CPR on an individual in a care home who had stopped breathing.

NMC panel did not find evidence of the considered judgment expected in the guidance This is why the suspension was imposed

Ms Nasiri failed to perform CPR on the 89-year-old woman, despite being aware there was no do not attempt resuscitation (DNAR) notice in place.

NMC

Nurse regulator’s Andrea Sutcliffe enters debate about its suspension of nurse who did not attempt CPR


Picture: Science Photo Library

The head of the Nursing and Midwifery Council (NMC) has moved to clarify in her own words the regulator’s position on when it expects registrants to perform cardiopulmonary resuscitation (CPR).

Andrea Sutcliffe's blog post comes after a recent high-profile fitness to practise ruling in which experienced nurse Nahid Nasiri was suspended from the register after failing to attempt CPR on an individual in a care home who had stopped breathing.

‘NMC panel did not find evidence of the considered judgment expected in the guidance… This is why the suspension was imposed’ 

Ms Nasiri failed to perform CPR on the 89-year-old woman, despite being aware there was no do not attempt resuscitation (DNAR) notice in place.

NMC requires such clinical decision making to be demonstrable 

Responding to concerns over the decision made in Ms Nasiri's case, NMC chief executive Ms Sutcliffe says her organisation supports best practice guidance drawn up by the British Medical Association, the RCN and the Resuscitation Council (UK).


Andrea Sutcliffe
Picture: Barney Newman

This emphasises a presumption in favour of beginning CPR when no DNAR is in place. Importantly however, healthcare professionals have discretion to depart from this default position on the basis of careful, considered clinical decision making, a point explicitly acknowledged by Ms Sutcliffe in her latest blog post.

'The NMC panel did not find any evidence of the careful, considered judgment expected in the guidance when Mrs Nasiri failed to perform CPR,' Ms Sutcliffe writes.

'This is why the sanction of a 12-month suspension from the register was imposed,' she explains.

Ms Sutcliffe adds it was 'key' Ms Nasiri had 'disengaged' from the fitness to practise process, and that the case presenter said Ms Nasiri's conduct would have been easily remedied with training, reflection and supervision. 

Advance care planning and the responsibilities of care providers

She adds that the case highlights the responsibilities of those in charge of running health and care services to ensure difficult, but clearly understood conversations about end of life care take place at the appropriate time.

The blog follows debate on social media and a Nursing Standard article by nurse and academic lawyer Marc Cornock that addresses the potential practice dilemmas facing nurses in light of such cases.

Ms Nasiri, who has since retired from nursing, has 28 days from the NMC ruling to appeal the decision.

Read Andrea Sutcliffe’s blog


Further information

Decisions relating to CPR: guidance from the British Medical Association, RCN and Resuscitation Council (UK)


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