[ajaxgirl]

I am wondering about LTC facility's, are most of the patients DNR? As a nurse how often do you have to do CPR on patients? I would expect most of them are DNR. I am considering getting a job in LTC as an RN.

[VivaLasViejas]

I have never had to perform CPR in long-term care, although some residents (almost always the most frail ones in the building) were full codes. My mantra was, "When in doubt, ship 'em out"--if a resident started going bad, I called 911 and sent them to the hospital. The crash cart in many LTC facilities consists of a suction canister, bag-valve mask and an oral airway---no drugs, no IV equipment etc. Running a code would have been a joke. So......off to the hospital they went, and if we (and they) were lucky, they passed away there before having to be put on the vent, feeding tubes, etc.

[ajaxgirl]

That's good. I would do the same. I just wouldn't want to be doing CPR on some of those elderly residents. Thanks for your reply.
I have never had to do CPR and hope I never have to.

[Monica RN,BSN]

Sadly enough, Not nearly enough of them in LTC are actually DNR's. We ship 'em out as well, as opposed to the alternative of having to do CPR. We have had to do it though, but not real frequently. Only about 3-4 times in the past year and half I have been in LTC in the place I work.

[Just Angi]

When I reach that point in life- I think I will have DNR tatooed on my forehead. That way no one will misunderstand. So many times by the time people reach LTC the family is making that decision. I suggest that if you don't come to see your relative but once or twice a year, don't make them suffer with making them full code. I wish everyone was required to have a living will at the age of 18. That way, whether it is old age, a wreck, or anything else that will alter the mind the person will have the wishes they have for themselves carried out.

[VivaLasViejas]

I had to do compressions once on an 89 YO lady who probably weighed 80# and had such severe osteoporosis that she had fractured her hip just by trying to get up from her wheelchair. ORIF was done on the insistence of the family, who were in the hallway arguing with her PCP about her full code status just as I was calling the code. Her post-op vitals had been heading downhill ever since she'd been brought to the floor, and suddenly she dropped her pressure to nothing. Having never done CPR on a real person, I was unprepared for the sickening sensation that travels all the way up your arms when you fracture ribs, and I almost freaked out. (I still get chills just thinking about that first time.) Thank God the doc FINALLY talked some sense into those people---that, and the fact that they all heard that first "crunch" made them realize hey, maybe we're not doing Granny any favors here---and we were permitted to stop the code when she flatlined.

Again, as I stated on another thread, I feel this is cruel and unusual punishment, and I can't imagine why anyone would put a fragile, sick elderly relative through it. I know a male nurse who has DNR tattooed directly over his heart, and several of my friends at work (along with myself) are DNRs as well, even though we're all still (comparatively) young and healthy. If the only other option is suffering interminably, I'd rather not, thank you!

[shygirl]

Hi, Most of ours are DNR. The few that aren't, we call 911!
I'v never had to do CPR on a resident.

Shygirl

[NJ LNHA]

I agree not nearly enough are DNR's. As a former social worker in LTC I tried to educate my residents and families as much as possible about making grandma a DNR. I went as far as to implement docimentation for out of hospital DNR's in case they coded in the ambulance on the way to the hospital. My nurses have called codes and started CPR, it's not pretty. I always wanted to find some type of video to show my families what really happens, even though that would have been a little morbid.

[PROFETA548]

HELP!!! DOES ANYONE KNOW, HOW OFTEN IN LTC ONES HAS TO REVIEW THE DNR--- SOME HAVE IT- FROM THE HOSP. THEN THE SW JUST INTERVENE IF THEY STILL WANT TO RENEW IT, FOR OUR FACILITY.. THEN, WE DO HAVE PT'S, THAT DO GET MUCH BETTER.... HELP THANKS

[NJ LNHA]

My experience has been reviewing the DNR quarterly with the care plan and family/resident. Which of course does not mean a good social worker or nurse should review with the resident if the resident rallys. Then again we all know what happens sometimes when a resident rallys. . . .