I have just completed a set of nights fulfilling the SHO post. I was covering back of house when I was called by a nurse from the ward. I could hear the emergency buzzer in the background.

She said, 'A patient has died and he doesn't have a DNACPR.'

'You need to put the crash call out.'

I was at that time in the AMU and ran as fast as I could to the other side of the hospital where the ward is.

I was the first doctor to arrive. This was my first actual crash call as a doctor, alone, until another junior doctor arrived. I was still the most senior doctor around for a good five minutes.

One look at the patient and I am cursing inside. He did not have good functional reserve.

The nurses had started basic life support. I asked why hasn't this patient have a DNACPR.

'Pause please, pulse check to confirm arrest.'

'Start the time. Continue compressions, please.'

The Crash team arrived several minutes later. Advanced life support commenced; a team of doctors and nurses working together on compressions, getting a gas, supporting airway, and cannulating.

The patient did not survive.

That night, I learnt the importance of always considering an escalation and resuscitation plan for every patient and during each admission.

It's not something that is plastered to a patient's care as a condemnation to their frailty or death. It's acknowledging when to act and to retract. It is also the most compassionate and ethical thing you could do for your patient, no matter what grade you are.