Joint NMC/RCN statement regarding Decisions Relating to Cardiopulmonary Resuscitation (CPR)

Published on 30 March 2020

This statement is intended to reiterate and augment our position regarding CPR decisions, which was initially published in 2017.

Guidance was developed jointly in 2016 by the Resuscitation Council, BMA and RCN called ‘Decisions relating to cardiopulmonary resuscitation’. The NMC remains supportive of this guidance.

While the guidance recommends that: "Where no explicit decision about CPR has been considered and recorded in advance there should be an initial presumption in favour of CPR", the guidance clarified: “ ‘…an initial presumption in favour of CPR’ …does not mean indiscriminate application of CPR that is of no benefit and not in a person’s best interests.”

Section 8 of the guidance states that: "…there will be cases where healthcare professionals discover patients with features of irreversible death – for example, rigor mortis. In such circumstances, any healthcare professional who makes a carefully considered decision not to start CPR should be supported by their senior colleagues, employers and professional bodies."

In both of the situations described above, where a decision is taken not to start CPR in the absence of a prior decision not to attempt resuscitation, the NMC fully supports Nurses and Midwives, and Nursing Associates in England, to use their professional judgement to decide what action should be taken in the best interests of the person in their care. All our registrants must uphold the standards in the Code, which are useful to support decision making.

A key issue is the way professionals evidence how they have used their professional judgement to make this important decision. Whenever professionals make a decision, in this or any other situation, it is incumbent upon them to be able to explain how they applied their professional judgement to support it. This should include being able to articulate the rationale for their decision and demonstrate what evidence they used. In order that their decision making process can be understood by others who have a legitimate interest, they should then formally record their decision making process, the action they chose to take, and the outcome.

It is the duty of health and care provider organisations to have appropriate evidence based policies in place, to provide the appropriate education and training for those working in an environment in which they may encounter death or cardiac arrest, and to ensure that best practice in line with Resuscitation Council guidelines is implemented.

-

Related pages

Blog: Reflections on recent CPR fitness to practise case


Other recent news…

NMC strengthens decision making guidance on concerns outside professional practice

Published on 27 February 2024

We have strengthened our guidance for NMC decision makers on concerns arising outside professional practice, including sexual misconduct, domestic abuse and dis


Independent experts appointed to review our internal culture

Published on 13 February 2024

The NMC has appointed Nazir Afzal OBE and Rise Associates to lead an independent review of our internal culture, as part of our commitment to learn and improve


NMC response to CQC maternity survey results 2023

Published on 09 February 2024

Following the release of the Care Quality Commission’s (CQC) latest annual survey of women’s maternity care experiences in England, Andrea Sutcliffe, NMC Chief