Copies of a DNR from a different facility/hospital?

[gentlegiver]

I sent a patient out to the hospital believing this person was a Full Code. I then called the On-Call who informed me this patient was a DNR/CMO. I did not find a DNR or CMO form in the chart (neither did the Nurse 's before me). At shift change, another Nurse found a copy of a DNR form in the chart (not in the area where it belonged). My question is this... Is a copy of a DNR from a different facility/hospital valid?? I was always told I had to have the original for it to be valid?

[Asystole RN]

DNR means do not resuscitate and has specifications such as antibiotics, g-tubes ect...

If a DNR is experiencing complications oxygen and suctioning are most often allowed. These are comfort measures and should be included in the DNR. Or if they fall and break something then most certainly they must be sent out but to keep in mind no cpr rule and whatever else the DNR dictates.

If someone makes a mistake in LTC and calls 911 for a DNR it is too late when the EMT's arrive because they have a duty to serve the call as a full code.

This actually happened at a LTC place in Hawaii I worked at and when 911 came through the door I was so shocked. The charge did not know the client was a DNR and the EMT's took her anyway even though I tried to clarify but it was too late. That poor women ended up on a feeding tube and lived another 6 months. It was truly sad.

It is our experiences in nursing that can make us better at what nurses do. This is why I'm such a stickler when it comes to codes and knowing exactly who is what. That women should have never been resuscitated.

Depends upon your State. In Arizona for example in the Arizona Revised Statutes states Emergency Medical personel are protected under law from criminal, civil or professional judgement as long as they believe they are serving the patient's requests. If they have a DNR or find out they are DNR and believe it to be accurate in good faith they they can stop the code.

All depends upon State law.

[Asystole RN]

Yes but DNR and comfort measures are not interchangeable terms-that's what I meant.

I think thats why the OP made the distinction of DNR/CMO instead of just CMO or DNR. OP states innability to find DNR or CMO prior to sending the patient.

[tyvin, BSN, RN]

Yes, yes in Hawaii at that time that was what the EMT's sited as the reason they had to follow through with the code.

It's like the nurse practice act; every state is different.