Full Code patients in Long term care

[beatrice1]

Occasionally in Long term care you have the family who Keeps their loved one on Full Code, even after patient is nearing their "End of life"

Sometimes Patient has chronic illness or no quality of life but family members think they need to "do everything for their parent"

My question (although may seem like a dumb question)

If Patient passes away, and they are not found (say in the middle of the night) right away, they are Obviously deceased. Are you suppose to do CPR no matter what/when you find them? Is there ever a time you dont do CPR?

What is the Ethical/responsible/ proceedural thing to do?

Bea

[Nascar nurse, ASN, RN]

Right before I left my last place of employment, I got into an argument with the interim administrator. He was telling the nurses they MUST do CPR even if the patient signed a DNR or a MOLST indicating no resuscitation if the doctor hadn't signed the order. I said that I would rather take a tag from the DPH than go against a patient's written wishes. It's very easy for people who aren't clinical to pass judgment on those of us who deal with this every day.

This is actually addressed in the new rules of participation as well. It essentially states that that you are to follow the resident/responsible party wishes if you have been unable to get a physician written signature.

Again, you'd want that in your policy, you'd want 2 documented witnesses if this was only verbal instructions and you'd want to document your butt off to cover yourself.

[OrangeSlushie, RN]

Occasionally in Long term care you have the family who Keeps their loved one on Full Code, even after patient is nearing their "End of life"

Sometimes Patient has chronic illness or no quality of life but family members think they need to "do everything for their parent"

This is when I try to be proactive with my families. A lot of families feel like they need to keep Mom (or whoever) a full code because they do not understand health care and think if they say DNR that it makes them monsters who don't care if Mom dies. We, of course, know that isn't the case at all. It's our job to help them understand that.