Survey of junior hospital doctors' attitudes to cardiopulmonary resuscitation

Abstract

Most cardiac arrest teams are made up of junior doctors. The stressful effect of cardiopulmonary resuscitation (CPR) on doctors has not previously been established. A questionnaire was sent to all 52 junior doctors who participated in the cardiac arrest team at a district general hospital. Forty one questionnaires were returned by 22 junior house officers, 12 senior house officers, and seven specialist registrars. The questionnaire was anonymous so non-responders could not be recontacted. Seventy three per cent found CPR stressful. The main reason for stress was the inappropriateness of CPR on the individual patient (12), poor outcome (13), no advanced life support (ALS) course (4), and the procedure itself (4). Fifty four per cent felt the number of inappropriate CPR had increased in the last six months with the main reason given (48%) being failure of senior staff to make "do not resuscitate" orders. Ninety seven per cent felt some CPRs were inappropriate; 70% felt a debriefing session should occur after CPR, while 88% reported not having one. Seventy six per cent felt competent at performing CPR, 22% felt incompetent of whom none had undergone ALS training. Fifty eight per cent found it difficult to discuss CPR with patients; 46% found it difficult to discuss CPR with relatives. Most junior doctors feel stress from CPR. Adequate review by senior doctors with documentation of do not resuscitate orders where appropriate, after discussion with patients, might be beneficial. Adequate training, improving communication skills, and support for junior doctors in the cardiac arrest team need to be reviewed since improvement in these areas may reduce stress.