"Goals of Patient Care"

My relative (who raised me and I consider to be my parent) was admitted post-fall to Bunbury Regional Hospital (BRH) after being transferred from another hospital. No Goals of Patient Care (GoPC) was completed on arrival or admission to BRH. A few days after admission when I arrived to visit them, I enquired about their GoPC and was informed it was not yet completed. I know they wouldn’t want to be resuscitated, but this was not documented as their wishes on the GoPC because I believe no doctor had spoken to my them about their care or their last wishes.

That day my relative was taken for emergency surgery (unrelated to their fall) and despite them having a significant anaesthetic risk, still no GoPC was done. While in surgery I was contacted by the surgeons and the ICU doctor wanting a private meeting. My relative was unstable and threatening to arrest and might not pull through. I now had to make decisions regarding their possible arrest and actions that would be taken should that occur. I do not have EPG, my other family member does, but I was there and listed as second NOK, so I made the decision that no CPR nor invasive lifesaving interventions were to be taken. Yet still, no GoPC was completed and I believe there was inadequate documentation written and handed over to the next shift of doctors as to what those decisions were.

My relative survived the surgery and began breathing on their own, they were admitted to ICU and I was allowed to see them. They were very weak and struggling to breathe, and I think they were a little confused. My last words to them were “I love you” and for that at least I am grateful.

I spoke with the nurses in ICU before I left and again expressed my concerns that no GoPC was completed and informed them of my decision should my relative arrest. But close to midnight I was phoned by the ICU doctor stating that my relative had arrested and they were currently performing CPR.

I had to tell them to stop. I had to say, let my relative die.

This should not have been my choice to make.

I should not have to carry the weight of this.

I know this is what my relative would have said, but it should not be my words that let them die. It should have been their words, their choice.

But the medical team at BRH did not give them that choice.

GoPC is such an important document, please don’t ignore it. Don’t assume someone else will do it. I know it’s a hard conversation, but the conversations I had were so much harder. This made the death of a loved one even more traumatic because I will carry this decision with me for the rest of my life.