DNR's

Specialties Geriatric

Published

I am wondering about LTC facility's, are most of the patients DNR? As a nurse how often do you have to do CPR on patients? I would expect most of them are DNR. I am considering getting a job in LTC as an RN.

i agree with nj lnha. that is an excellent practice. :bow:

the resident must have a preferred intensity of care when admitted, which includes cpr, tube feeding, iv's, antibiotics, transfer to the acute care hospital, gastrostomy/nasogastric tube feeding, etc.

as an ex-surveyor i don't really think there is any regulation per say but it is something you review with the idt (including the social worker), family/resident on a quarterly basis, change of condition and prn.

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When I reach that point in life- I think I will have DNR tatooed on my forehead. That way no one will misunderstand. So many times by the time people reach LTC the family is making that decision. I suggest that if you don't come to see your relative but once or twice a year, don't make them suffer with making them full code. I wish everyone was required to have a living will at the age of 18. That way, whether it is old age, a wreck, or anything else that will alter the mind the person will have the wishes they have for themselves carried out.

Don't take this wrong. Hopefully with the tattoo of DNR others will know your wishes. Just remember DNR doesn't exclusivly mean do not recuscitate. It'd be my luck to collapse in a national forrest and the person that finds me thinks I'm an employee (dept. of natural resourses).

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Specializes in Gerontology, Med surg, Home Health.

It's not just DNRs that create ethical dilemas. We have a woman with significant dementia who is on Hospice...also has skin cancer. She has a lesion on her leg which has started to tunnel. The nurse is beside herself because the family doesn't want to do anything but keep her comfortable. This is what I told her: Is she in pain now? If not and the prospective treatment would cause her pain, then what is the point. Having the wound/lesion debrided will not improve her quality of life and may cause her pain. Sometimes you have to look at the basic things...pain vs. comfort.

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My mother made herself a DNR when she entered the nursing home(her decision). I have done CPR on NH patients more times than I care to admit and I can not remember not breaking ribs. I always have that sinking sick feeling for a while afterwards.

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Specializes in Rehab, LTC, Peds, Hospice.
After reading your post, I feel better about the DNR decision I made for my elderly mother. She passed away ,in the hospital, 3 weeks ago, and I have struggled with guilt about the DNR decision I made. I'm not a nurse but I work in the medical field. When the attending nurse told me my mother was gone (died in my arms) my first instinct was to do CPR on her. I started to, then my gut told me to let her go. Now, I'm second guessing myself because I miss her so. I hope I did the right thing.

Hacamila, I am sorry for your loss! I don't know if it helps but even when we have had to do CPR for our elderly residents, most did not make it and the ones who did were weakened further, really affecting their quality of life. I want for my loved ones to spend their last days as comfortable as possible (for myself as well). Having spent many years taking care of people whose family members made different choices, makes it easier for me to say let nature take its course.

I'm glad that you were able to be there with her, although I am sure it was and is very hard on you. God bless.

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At my facility you would be suprised how many people are FULL CODE. Right now we have a 90 year old woman who weights about 90 lbs who is one. I would hate to be the one doing CPR on her. Most are DNR-Arrest and of course some are comfort care only. But when I started doing MDS et started looking through all the charts from all the floors, I could not believe how many are still Full. And no amout of talking seems to change their minds or the minds of the family.

Leslie

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I know a male nurse who has DNR tattooed directly over his heart, and several of my friends at work (along with myself) are DNRs as well, even though we're all still (comparatively) young and healthy. If the only other option is suffering interminably, I'd rather not, thank you!

I feel exactly the same way...when your number is up, your number is up. I don't want CPR done on me. I think CPR is overrated in its value, anyway.

On the other hand, I would be a hypocrite if I said I wouldn't do it on one of my children or my husband, I can't bear the thought of losing them, even as remote as the possibility was it would be successful, I would give it all I had, but for myself, let me go.

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Specializes in Gerontology, Med surg, Home Health.

We had a difference of opinion at one place I worked over DNRs. There were 2 docs there...one old and really creepy. If he was on the floor, I was definitely a DNR. However, if the young, 6'3" blond blue eyed doc was there......bring on the mouth to mouth!!!

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