DNR status

Liddle Noodnik · Jun 16, 2003

Originally posted by MICKEY73
I have worked in long term care for the past 8 years. We have many residents that are DNR's but suffer from acute conditions that require a ER visit. The ER gives us the run around about sending residents that are DNR's. I am wondering how other long term care nurses feel about this issue.

Unless they also have a DNH (do not hospitalize) we send them.

Also, if it is a questionable thing I often consult with family BEFORE I call the doc.

It's a tough position to be in, isn't it?

What I hate is if the family WANTED Dnr but no one took care of it ahead of time.

Chttynurs · Jun 16, 2003

I'm not a long term care nurse, so maybe I'm wrong here...but as far as I'm concerned, DNR means do not RESUSCITATE. If you're sending them to the ER then I assume they're not already dead, but alive and in need of more treatment than a long term care facility can provide. Like I said, I could be wrong, but that's my opinion.

Cubby · Jun 16, 2003

Just because the resident is a DNR does not mean they are not

treated for acute illnesses. Why can the ER docs not get this?

All a DNR means is that if you find them DRT you don't code them.

Period.

CapeCodMermaid, RN · Jun 16, 2003

If more families understood what DNR meant, there would be less of a problem. The docs at the hospital here aren't so bad. What bothers me is when someone is admitted and the quality of their life is horrid (gtube, dialysis,colostomy all at the same time) and the family won't sign a DNR.

GAstudent · Jun 16, 2003

Where I work we first call the family and ask their opinion. If they wish that we send the resident on to the hospital then we do so. We have a lady right now who is a DNR and she has been in and out of the hospital numerous times in the past month, well on Friday we walked in and she looked as if she has had a stroke (all the signs) well I got the nurse and we called her family and they did not want to send her to the hospital again. Where I work it is the family who decides. I think that it is wrong. If my husband was 100 years old I would still want them to help. If I could have just one more day with him what would I do? I can think of so many. It is a personal opinion and varies from person to person. I know that when God decides it is time then it is time but I still wish for someone to help my family members. I can't just sit and watch someone die.

agnewRN · Jun 21, 2003

Originally posted by GAstudent
Where I work we first call the family and ask their opinion. If they wish that we send the resident on to the hospital then we do so. We have a lady right now who is a DNR and she has been in and out of the hospital numerous times in the past month, well on Friday we walked in and she looked as if she has had a stroke (all the signs) well I got the nurse and we called her family and they did not want to send her to the hospital again. Where I work it is the family who decides. I think that it is wrong. If my husband was 100 years old I would still want them to help. If I could have just one more day with him what would I do? I can think of so many. It is a personal opinion and varies from person to person. I know that when God decides it is time then it is time but I still wish for someone to help my family members. I can't just sit and watch someone die.

I can understand how you may think this, but think of what this poor resident has gone through in the past by going in and out of the hospital. Has it really improved her quality of life? Has she returned to her previous health status or better? Probably not. Most residents I work with have soo many chronic medical conditions which can never be improved. It is a constant struggle to keep them stable. And it is one thing after another. How would you feel if everyday it was a struggle for you to get washed, dressed and just have basic needs done. Bodies tire out eventually and the best sometimes is to keep them comfortable and meet their needs. It's stressful to go to the hospital- tests are done , people in and out disturbing you, isolated from environment and caregivers you know, little rest,etc and for what kind of quality of life ? I think the family has made a wise decision, and spared their loved one from more stress. Try and remember what is right for you or your husband may not be right for someone with chronic severe medical conditions. Your husband probably would have a better chance at returning to a higher quality of life than these elderly and fragile residents.

Thanks