DNR orders - page 2

After having once again witnessed a doctor ask a patient (this time a 91 YO) "if your heart stopped would you want us to do anything?" and then write orders for a full code without any further... Read More

  1. Visit  Fiona59 profile page
    0
    I once had a patient who was a DNR and "saved" by a good intentioned passerby. He was a very angy, frustrated man. Bitter towards everyone related to healthcare. He had made his peace and was ready to go and was brought back.
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  3. Visit  IowaKaren profile page
    0
    Yes, I've seen the little old man as a full code and we worked for what seemed like an hour to bring him back, fly him out to a larger facility, then a week later shipped back to us to die in Hospice care. Sad
  4. Visit  mama_d profile page
    1
    I have actually used the words "It's not like you see on TV in shows like ER when we code a patient" to family members when they ask. The first time, it just popped out, not the most tactfully either to my chagrin. However, the family was receptive to that statement and wanted to know just how it was different...and went on to become angry at "those people who make those shows" for the inaccuracies usually portrayed. I have come to use that situation as a building block for discussion with subsequent families..."I know most people just have a vague idea of what a code involves based on what they've seen on TV and in the movies, and that's usually not accurate. Why don't you tell me what your impression is of what occurs and we can figure out where you've been misinformed, so you can make the decision based on the facts."

    We also have to ask about advanced directives with our admit paperwork, which gives a great opportunity to broach the subject with patients/families, and to explain the different levels of care available (medical management vs. comfort care). Thankfully, our hospitalist group (which sees on average 50-75% of our patients) is pretty good about listening to the nurses about this when we have suggestions for who would be open to DNR status.
    LPNnowRN likes this.
  5. Visit  pielęgniarka profile page
    3
    I happen to enjoy this video about DNR-- I think in certain circumstances the message really applies.

    It is rarely explained to patients well what DNR status is.

    http://www.youtube.com/watch?v=OVx2mjjBvis
  6. Visit  LovingNurse profile page
    0
    Quote from sfrek1214
    I happen to enjoy this video about DNR-- I think in certain circumstances the message really applies.

    It is rarely explained to patients well what DNR status is.

    http://www.youtube.com/watch?v=OVx2mjjBvis
    Wow! Thanks for sharing this. :bowingpur
  7. Visit  MADHAT6 profile page
    0
    Just having a living will and a DNR is not enough,i have an 86 yr old family member with both of these,and a partner with a POA who supported him,and when he requested palliative care after an obstruction,was denied palliative care,told he had no option but surgery,he also has diabetes/CHF/COPD/Vascular dementia/Peri[heral vascular disease and has been in severe chronic pain for 20 years,when he woke up from the surgery he again requested palliative care,and even though his primary doctor and his psychologist supported him,he was overruled by the surgeon.
  8. Visit  LovingNurse profile page
    1
    Quote from badhat6
    Just having a living will and a DNR is not enough,i have an 86 yr old family member with both of these,and a partner with a POA who supported him,and when he requested palliative care after an obstruction,was denied palliative care,told he had no option but surgery,he also has diabetes/CHF/COPD/Vascular dementia/Peri[heral vascular disease and has been in severe chronic pain for 20 years,when he woke up from the surgery he again requested palliative care,and even though his primary doctor and his psychologist supported him,he was overruled by the surgeon.
    Who signed the surgical consent form?
    imintrouble likes this.
  9. Visit  TiredMD profile page
    6
    Quote from calledtodo
    What if a patient who is DNR is resuscitated and is brought back to life? What is the next step or what usually happens when this occurs? Just curious.
    Usually we very politely and respectfully appologize to the patient, explaining that it was an error.

    Then we . . . you know . . . kill them.



    [j/k]
    LPNnowRN, sharpeimom, Roy Fokker, and 3 others like this.
  10. Visit  Babs0512 profile page
    0
    LOL, reminds of a SLOW CODE or two I've been in.
  11. Visit  Magsulfate profile page
    0
    Quote from TiredMD
    Usually we very politely and respectfully appologize to the patient, explaining that it was an error.

    Then we . . . you know . . . kill them.



    [j/k]
    :roll:roll:roll
    hehe omg
  12. Visit  mscsrjhm profile page
    0
    Kardex indicates DNR or AD, reported by off going shift that pt is a DNR or has AD, but there is a 50/50 chance that this is actually addressed on the chart. I have to address the issue with a patient almost every shift- and the answer is frequently: "I have been here before- they have it on file". Working agency, different hospitals, yet oddly, this is a common response.
    Where is this file?
    The other answer is always: "it's at home- do you need a copy?"
  13. Visit  Magsulfate profile page
    1
    Quote from Nurse4years
    Kardex indicates DNR or AD, reported by off going shift that pt is a DNR or has AD, but there is a 50/50 chance that this is actually addressed on the chart. I have to address the issue with a patient almost every shift- and the answer is frequently: "I have been here before- they have it on file". Working agency, different hospitals, yet oddly, this is a common response.
    Where is this file?
    The other answer is always: "it's at home- do you need a copy?"
    grrrr Don't you just hate that?? Some patients/people just don't realize that those papers are absolutely no good at home.
    mscsrjhm likes this.
  14. Visit  LovingNurse profile page
    0
    "At home" is at least better than "In the safe deposit box."


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