This may have seemed like a frivolous exercise, but in my experience as an agency nurse, I have been told everything from withholding CPR to withholding suctioning, insulin, and enteral feeding when they had already had a PEG tube placed. It is very frustrating to walk into a situation where a swift, rational decision needs to be made, and that decision is misinterpreted as challenging an institution's standard of practice.
In one particular situation, I was working as a RN Shift Supervisor. A resident with a PEG tube, in a semi-vegetative state began to aspirate feeding solution, secondary to not having the head of the bed elevated after being turned by the NA's on care rounds. When I found this resident, she was ashen, gasping, and struggling for breath. I suctioned her aggressively, and supplemented oxygen by bagging her for two to three breaths. She began to breathe on her own, and a nasal cannula was applied with oxygen until her color returned to normal.
Another nurse working on a separate floor began to be very vocal, and very critical of my decision to "resuscitate" a DNR, which divided the staff. The Nursing Director of the institution did not criticize my performance. But as a result of the incident, I have elected not to return to this particular institution, as their policy was unclear, and this had not been the first time that as a nursing supervisor, my interpretation of an ambiguous policy was neither exonerated nor corrected.
Keeping the Faith