DNR orders - page 3

Do you know the DNR/full code status on all your residents off the top of your heads? Seriously. Forget the bracelets or other ways that indicate a DNR. (except the doc's order) You may think he/she... Read More

  1. by   Balder_LPN
    Quote from student4ever
    We had EMS bring a pt. in the other day c/o diff. breathing, who had a DNR. Sats were decreased, pt. was barely holding on - had she not had the DNR, EMS would have intubated her pre-hospital. But b/c of her DNR, they had her on a non rebreather. She died at triage. And no one touched her, because of the DNR. EMTs do not resuscitate as long as they see a signed DNR.
    Do you actually mean "no one touched her", what about comfort care short of resusitation?
  2. by   nialloh
    Quote from Balder
    Do you actually mean "no one touched her", what about comfort care short of resusitation?

    If all her vital signs are going down, the only comfort care tx you can give is O2. Any thing else is to revive her. Morphine, ect will only depress her resp even more. Sometimes, all you can do is hold their hand and say goodbye.
  3. by   joyflnoyz
    Quote from nialloh
    If all her vital signs are going down, the only comfort care tx you can give is O2. Any thing else is to revive her. Morphine, ect will only depress her resp even more. Sometimes, all you can do is hold their hand and say goodbye.

    WHAT!!???

    Do Not Recusitate doe **NOT** mean do not TREAT symptoms.
    In the two states I've worked, it means if a patient is found <apparently>
    dead, you don't start CPR. Perhaps the state you work in has different view.

    Respiratory distress does not mean she's dead.

    As for morphine...heck hospice pts get it all the time. Frequently.
    The point is to relieve discomfort. By NOT treating the discomfort, all involved were guilty of not caring properly for the patient. As for "hastening death", legally, it's all about *intent* <there was a short article in one of the nursing journals about a year ago which explains it much better than I>

    Reading back thru the posts, the DNR papers when on a lady who went on to respiratory distress and passed out IN A PRIVATE HOME. I probably woulda called 911 too. Who else wold you call for for a police/EMS emergency? If the woman had died in the home, the police would have to be called anyway. Documentation and legalities and all that..
  4. by   nialloh
    Quote from joyflnoyz
    WHAT!!???

    Do Not Recusitate doe **NOT** mean do not TREAT symptoms.
    In the two states I've worked, it means if a patient is found <apparently>
    dead, you don't start CPR. Perhaps the state you work in has different view.

    Respiratory distress does not mean she's dead.

    I agree, but I don't have a pt in front of me, so I'm doing a lot of guessing. I am assuming (maybe wrongly) that the pt was not conscious considering how fast she passed on reaching the hospital. You can give O2, resp tx, ect., but you can't put her on a vent, which is what she needed. She died in triage, so the nurse might not have had much time to do anything.
    As to the morphine, you are correct. I didn't express my thought correctly. I was still thinking of her living, and that morphine would kill her. For comfort care while passing, you are exactly correct.

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