DNR orders - page 6

by Erin 24,193 Views | 53 Comments

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 explanation to the pt of what this... Read More


  1. 3
    I wish we could show patients and families a video of a real code so they could see what really happens. Sometimes explaining it still doesnt sink it. We do not use DNR bracelets where i work but i think we should. I can not tell you how many times myself or another nurse has walked into a room to find a pt either dead or very close to it. If this is not your patient you do not know their code status without looking at their chart. A bracelet would make it a lot easier to know how to initially respond to the situation.
    marthyellen, mskate, and imintrouble like this.
  2. 0
    I wonder what the family would say if they could feel a rib crack, or witness the pain everytime the ventilator inflated that lung.
    Makes me cringe everytime I think of it.
    Absolutely an informational video should be part of a signed DNR.
  3. 2
    I firmly believe that every.single.hospital should have an MD, an RN with ICU experience who has worked with the really bad "do everything" population, and a social worker to sit down with patients early on in the admission to talk about code status, palliative care, pain management and *realistic* options.

    Nurses who have 6 other patients with each admission, and docs who are running around with their patient load don't usually have the time to sit down and spend the 30 minutes, an hour, or so to really explain things, learn about patients and their fears, etc...

    I think it would be a fantastic program to have in every hospital.
  4. 0
    I am again so greatful for my job and most of my colleagues after reading some of these posts. When code status is addressed, we have three levels of DNR. In explaining these, I think it helps so the patient/family understands the DNR doesn't mean do nothing/do not treat. We use DNR bands and the POLST is the first page under physician orders.
    For those physicians who do not address code status, I will make this statement when I round with the physician "Dr. X, we need to address code status." That simple. No beating around the bush. I've yet had a physician complain or "report" me. What could they really say? "She made me talk to my patient about their wishes?"


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