Jazi, a 59 year old man was admitted to the intensive care unit of a large metropolitan hospital with a diagnosis of septicaemia. Jazi was admitted to hospital for further treatment of his leukaemia at which time his PICC line site became red and inflamed. Communication with Jazi’s doctor occurred after 48 hours of noted redness when pain and a temperature also presented. The PICC line was removed and peripheral access gained. Jazi continued to deteriorate and at the time of admission to ICU he was pale, markedly short of breath, and had a temp of 42. After the ICU physician’s review he was immediately commenced on a regime of intravenous antibiotics. Jazi’s medical history included severe mitral valve stenosis and chronic myeloid leukaemia.
A few hours after Jazi’s admission to ICU, the shift handover occurred for the afternoon shift. During handover, the NUM informed the nursing staff present that she had received a phone call from the treating Oncologist advising the patient was not for resuscitation (NFR). The nurses continued with afternoon handover however they questioned why the patient had been transferred to ICU as he was NFR. Later in the shift the Oncologist called to see Jazi and indicated to him that the treatment plan was sorted and now the focus was to eliminate the source of infection that had occurred. The Oncologist questioned Jazi as to how long the PICC line had been red and sore and Jazi responded that it had ‘been that way most of the time I have been in hospital, however it did get a lot worse over the weekend.’ The Oncologist did not reply to Jazi. He continued to write up his clinical assessment report however did not document the NFR directive which he had phoned through earlier. This oversight was later dealt with by the nursing staff writ