Quite recently a friend (non clinical) asked me whether hypothetically if there was a medically critical situation would i choose a life saving intervention or otherwise? Instead i showed her my necklace which i always wear which states "Do Not Resuscitate in an emergency". She was shocked.
Now this decision was not done lightly. I have witnessed and performed many CPR's in my time. Personally i do think that CPR is an invasive, burdensome and punishing procedure. However, i would not deny anyone seeking this intervention.
Would you choose CPR or DNR? Kindly share your opinions.
I think it is very important to have a living will in place, regardless - to make your wishes known. Or get a trusted Healthcare POA on deck.
I am a full code. This of course, may change if something terminal were to befall me.
My living will states that if I have no brain activity, I am to be extubated and I am to be left to die. Do not feed me, do not go to extreme measures, do not let me live on machines.
Legally certified DNR? That makes no sense! Are you in the USA? If so I have never heard someone being allowed to become a DNR without some terminal or progressive illness, unless they are fairly elderly otherwise.
Not saying I agree with it, but that is just how it is here. No one wants to allow anyone to die. I believe that if someone has an illness they don't want to live with, despite the available therapies, and they are an adult over 25 then they should be allowed to be a DNR and/or given drugs for euthanasia. I do feel like adults should have the right to die when they want to and not when others feel its ok.
Annie
I've never heard of requiring a terminal illness to be present to allow someone to decline resuscitation or any other medical intervention. So long as someone is competent, they are free to decline medical interventions they don't want, including resuscitation, to provide those interventions to someone who has stated they don't want them is assault/battery.
The potential benefits of CPR and resuscitation vary widely from person to person, so it's not really possible to say it's unlikely to work as a broad statement. There are patients where we don't even offer full code status because it can be definitively determined that it won't be of any benefit, but then there are also patient we code where there actually isn't much reason to believe they won't recover, they just need a bit of compressions to get them through a 'spell'.
It depends on why CPR may be necessary. If my heart stopping is the end result of a terminal illness of course I don't want my suffering prolonged. If it's due to something reversible that I could survive without devastating quality of life outcomes then sure, go ahead and pound on my chest. An old instructor of mine put CPR efforts in terms I'll never forget: If a person/family decides on full code status for somebody that you know will never survive the effort make all the effort anyway. Not only are you legally required to do so, the eventual failure of CPR isn't the issue. At least the family knows you made every effort possible and the patient won't care that you broke a bunch of ribs, the patient is essentially dead and those broken ribs won't hurt. If a miracle happens and the patient is revived they sure aren't going to hold those broken ribs against you since you saved their life.
There's too many variables for me to give an absolute definite answer. If I went into cardiac arrest at my current age in my current state of health, then yes, I'd want them to do everything possible to bring me back. If you ask me when I'm 85 or after I found out I have a terminal illness, then my answer would probably be different.
I am 28 and am very healthy. Currently, I am a full code but have occasionally thought about changing my status to DNR/DNI as well as prohibiting other life-saving medical interventions. Like you, I am not opposed to providing them for other people, but my personal thoughts are, if it is my time to go, then it is my time to go. I am single with no children so I don't have any obligations, in that aspect. However, I have other family members that would disagree with this, so I have yet to actually do anything yet.
So many of you give the same answers that I find frustrating in patients. "Well I only want CPR if there is a good chance I'll recover."
Uh, we can't sit around and debate the chances of your code survival and/or call your family and ask what they think. It is all or nothing. I am 36. If I am in the hospital and not on a heart monitor than I am 100% a DNR. I don't care if there for a broken foot. A code wouldn't be started soon enough to be worthwhile. Even if on a monitor I'd be tempted to be a DNR.
And I have no shame about judging people for not being DNRs and no, I don't think "all nurses go to heaven." (??!). Ask most people how they want to die and peacefully in their sleep is the answer. But put them in a hospital and almost no one has an honest conversation with them about what a code involves and the statistics so they say don't let them die. Well they are probably dying it is just now in a horrible way. The best thing hospitals could do would have a team of doctor/nurse/etc who goes to EVERY patient and really talks to them about code vs dnr.
If some 82 year old wants me to break their ribs and put a tube down their throat then that is fine. They just need to know that is most likely the reality. Not what they see in tv.
So many of you give the same answers that I find frustrating in patients. "Well I only want CPR if there is a good chance I'll recover."
I don't think that is what most people are saying. Most who want CPR are saying that, in their current state of health, they would want CPR because it is likely, if started early enough, that they would make a meaningful recovery. That is a lot different than saying that they want it decided right as the code starts as to whether or not they will survive. Of course no one can predict that.
Not saying I agree with it, but that is just how it is here. No one wants to allow anyone to die. I believe that if someone has an illness they don't want to live with, despite the available therapies, and they are an adult over 25 then they should be allowed to be a DNR and/or given drugs for euthanasia. I do feel like adults should have the right to die when they want to and not when others feel its ok.
I am interested in how you came to choose the age of 25 years. Is there a particular reason? Just curious.
Does DNR mean no Heimlich maneuver? I can't imagine dying by choking is particularly pleasant, and that would seem to go against the spirit of being DNR.
Wow. What an amazing viewpoint. As a critical care nurse I have never heard of this maneuver. A super nurse Like yourself has taken something literal again... please tell me more. You are so insightful. If you have not prepared over 15 patients for procurement for gift of life you should not be commenting on what these “cadavers”‘go through. You are a super nurse!! Congrats ?
humerusRN, BSN
100 Posts
I think it is very important to have a living will in place, regardless - to make your wishes known. Or get a trusted Healthcare POA on deck.
I am a full code. This of course, may change if something terminal were to befall me.
My living will states that if I have no brain activity, I am to be extubated and I am to be left to die. Do not feed me, do not go to extreme measures, do not let me live on machines.