Just wondering, can a long term care/subacute nurse take an order for a DNR/DNI over the phone from an NP or MD in your facility? What are your policies?

Never, never NEVER take a phone or verbal order for something as serious as this. I have no idea what the policy is at my facility on acute vs. subacute but I would NOT accept a telephone or verbal order for a DNR/DNI.

I've been told by a doctor over the phone that I can take a verbal DNR order over the phone if I get another nurse to get the order from her too. She wanted to make sure that we didn't try to resusitate the pt. I told her I was uncomfortable taking the order over the phone and she needed to come in to write the order. She wasn't too happy w/ me but it turns out she already wrote the DNR order when she saw the pt in the ER so she was covered.

In our facility, the DNR order needs to be written and a purple DNR band placed on the pt's wrist. The band placement needs to be verified by two nurses at the start of every shift w/ the written order.

State laws must be considered. If you have any doubts contact you social worker. They deal with this issue a lot.

I had a patient who was a full code and the family decided when we were going to send her out to make her a DNR. Because the family could not get there and the doctor is not in the facility, we had to get an emergency 24 hour verbal DNR from the doctor. That meant that the patient was DNR but all paperwork had to be signed within 24 hours or the patient became a full code and the DNR became null and void.

I work in the ED and we sometimes have to take telephone admission orders. The hospital protocol states you can take a verbal/teltphone DNR/DNI if it is readback, verified, and signed by two RN's. The MD must then come in and sign the order with in 24 hrs. Supporting the patient/family's wishes is very important. Check into your hospital's protocol and support what it says

I really like the purple DNR band idea. I work in the ED and not on the floor but occasionally we have to respond to codes in other areas of the hospital...cath lab, rehab, cafeteria, outside grounds, radiology, etc. If pt from the floor had a wrist band this would be very helpful.

Yes, in an emergency, and with 2 RN's witnessing it. Same in most of the buildings here.

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Yes, I take those orders over the phone.

In the 'old' days when I first worked in LTC, we could take a verbal DNR if two nurses were listening in and both signed the order. Now we can NOT ever take a verbal DNR. It's not that much of a bother though because ALL the docs have fax machines and we can take a faxed order.