DNR does not mean Do Not Treat!!

leslie :-D · Sep 6, 2004

:angryfire I work in a nursing home and a lot of times when we beep a doctor that is on call for the week-end because we have a sick resident they won't let us send them to the hospital if they have a DNR on file? Did they learn in medical school that DNR means Do not Treat!!!!????

has any nurse questioned the md?

has any nurse reported to the md that said pt. is not a dnh.

and if it is a true emergency, you send them out, with or without an md order.

and finally, document document document.

leslie

laughingfairy · Sep 6, 2004

Yes I have run into the same problem...or MDs not calling back...or MD on call for medical director not available for call for medical director only for emergencies with his patients...its a horrible process...

Do you have a nurse or administrator on call...If you do, I would notify the supervisor and that person as well (or have the supervisor do it if staff nurses aren't supposed to) and I would document right in the nurses' notes...who I called...did you page direct or via service...who I spoke to...why I spoke to dr. x instead of dr. a. (i.e. on call)...times I called. who else i notified such as family or guardian...other interventions i tried...very strong assessment...not just of specific problem but entire body...heck do a skin check too if it doesn't comprimise the resident...just my 2 cents.

fergus51 · Sep 6, 2004

Don't you ask patients and their families about this?

butterflynurse · Sep 7, 2004

Don't you ask patients and their families about this?

we do, a lot of times they say they want to do what the doc says. If it is a true emergency, fall, possible broken bone, etc. we go ahead and send them. also if the family says they want them sent, we will beep the doc again and let him know that. with some of the docs when they call back i will say "i'm sending so and so out because" and state the reason

butterflynurse · Sep 7, 2004

has any nurse questioned the md?
has any nurse reported to the md that said pt. is not a dnh.
and if it is a true emergency, you send them out, with or without an md order.
and finally, document document document.
leslie

usually we have someone from administration on call and it's better if it's the don or adon because they are nurses also and understand what we are talking about.

9 times out of 10 the first thing the doc will ask is if the patient is a dnr or not.

i always document everthing, how many time the md was notified, vitals, if condition worsens and md was notified, family member notification and if they request patient be sent out or not, etc.... us nurses have to cover our @$$es.

butterflynurse · Sep 7, 2004

Yes I have run into the same problem...or MDs not calling back...or MD on call for medical director not available for call for medical director only for emergencies with his patients...its a horrible process...
Do you have a nurse or administrator on call...If you do, I would notify the supervisor and that person as well (or have the supervisor do it if staff nurses aren't supposed to) and I would document right in the nurses' notes...who I called...did you page direct or via service...who I spoke to...why I spoke to dr. x instead of dr. a. (i.e. on call)...times I called. who else i notified such as family or guardian...other interventions i tried...very strong assessment...not just of specific problem but entire body...heck do a skin check too if it doesn't comprimise the resident...just my 2 cents.

thanks for your reply i think i answered some of your questions in my previous post. sometimes after a bad day i have to vent. i guess all fellow nurses must agree:nurse: