DNR question - page 2
Hey, I had a patient yesterday and wanted to share a story, then get everyone's opinion. A 53 year old lady with a 40 pack/yr smoking history was admitted with end-stage pulm fibrosis and stage 4... Read More
Sep 10, '09Quote from annienhrnmy hospital has a renowned hospice unit -- so i'm told. the difficulty is, that even when we make a patient a dnr, we keep them in our icu. with monitors. many places don't have policies that allow for a nice, quiet, appropriate hospice room.i think what happened here is that the family did not have a clear plan in place with the doctor when she was made a dnr. this is the time when a doctor should talk about what the family's/pt's wishes are. what can they expect during her last days/weeks? what do they want done? he also needs to discuss hospice and what comfort measures would entail.
i am sorry you were put in the situation you were in. i understand when a pt is monitored and has vitals signs like you stated you were obligated to call the doctor. my question is why was this terminally ill pt with a dnr on a monitor? i think a quiet hospice room would have been more appropriate.
Sep 10, '09I agree with the OP's actions. At my hospital a DNR is simply a DNR. If a patient/family doesn't want pressors, intubation, shocks, etc, there is a difference. We use a DNAR form that has check boxes for every kind of intervention. There are some patients who want no shocks but cardiac meds, no intubation, but want to be cardioverted, etc.
I really like using this form because it clears up a lot of confusion.