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CPR guidance to be updated after controversial fitness to practise ruling

RCN says update will give nurses clearer direction on resuscitation decisions
Someone performing CPR on another person. The RCN says guidance on CPR will be updated to give nurses clearer direction

RCN says update will give nurses clearer direction on resuscitation decisions

National guidance on cardiopulmonary resuscitation (CPR) is being updated to help nurses justify clinical decisions to not perform it, the RCN has confirmed.

The move follows a controversial fitness to practise (FtP) ruling in which care home nurse Nahid Nasiri was suspended from the Nursing and Midwifery Council (NMC) register after failing to attempt CPR on a resident who had stopped breathing.

Ms Nasiri was aware that there was no do not attempt resuscitation (DNACPR) notice in place for the resident, but claimed she made a carefully considered decision not to perform CPR.

Concern over ambiguity in current guidance

Current guidance for nurses, from the British Medical Association, the Resuscitation Council (UK) and the RCN, emphasises a presumption in favour

RCN says update will give nurses clearer direction on resuscitation decisions

Someone performing CPR on another person. The RCN says guidance on CPR will be updated to give nurses clearer direction
Picture: iStock

National guidance on cardiopulmonary resuscitation (CPR) is being updated to help nurses justify clinical decisions to not perform it, the RCN has confirmed.

The move follows a controversial fitness to practise (FtP) ruling in which care home nurse Nahid Nasiri was suspended from the Nursing and Midwifery Council (NMC) register after failing to attempt CPR on a resident who had stopped breathing.

Ms Nasiri was aware that there was no do not attempt resuscitation (DNACPR) notice in place for the resident, but claimed she made a ‘carefully considered decision’ not to perform CPR.

Concern over ambiguity in current guidance

Current guidance for nurses, from the British Medical Association, the Resuscitation Council (UK) and the RCN, emphasises a presumption in favour of beginning CPR when there is no DNACPR in place.

Crucially though, it states that professionals can depart from this based on a ‘carefully considered decision’.

Following the ruling against Ms Nasiri, nurses expressed concern that nursing professionals could be penalised unfairly for deciding not to deliver CPR in circumstances where no DNACPR directive is in place.

This is the area of the guidance the RCN says will be updated to give clearer direction to registrants who may face such clinical decisions.

Evidence of the decision-making process related to CPR

RCN professional lead for community and end of life care Carolyn Doyle said: ‘We have been in contact with the NMC and are working on updating the guidance to ensure our members are able to articulate their decision-making process.

‘This is where difficulties arise in nursing – we have to be able to justify our actions and record them for evidence.’

While Ms Nasiri argued her decision not to attempt resuscitation was carefully considered, the NMC said it could find no evidence of this.

The regulator confirmed it is in the early stages of meeting with the RCN and says it ‘fully supports’ the best practice guidance.

A Resuscitation Council UK spokesperson says it has contacted the NMC to request inclusion on any roundtable discussion on updating the guidance.


Further information

Current CPR guidance


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