Note: This might seem like a strange topic, but seeing as how that is nothing new coming from the source, I'll go ahead anyway.
As nurses, we are trained to do everything we can to save someone until it's no longer feasible or unless doing so would go against a patient's wishes, such as performing CPR for a patient with a a DNR/DNI.
However, theoretically, anyone of us could "code" at anytime--and this includes at work.
For those who are full codes, this wouldn't create any ethical issues. You would simply perform CPR on your coworker as you would anyone else.
However, for those who have DNR/DNIs, issues could come up if coworkers are unaware such orders exist. How do we ensure that these coworkers have their wishes respected should the need come up?
For example, I am legally a Full Code but am wanting to pursue a DNR/DNI. Based on my age and no apparent health issues, I have a feeling most of my coworkers would automatically assume I am a Full Code should circumstances arise, however.
What is the best way to inform my coworkers that under no circumstances should anyone provide CPR to me?
For the rest of you, how do you ensure your coworkers' wishes for CPR or no CPR are ensured? Have you ever experienced such an ethical dilemma at work?
You and SilverBells both responded to me at the exact same time. What's up with that? Why does your inner woman seem so much less settled in their real-life relationships than you are? This thread and its side conversations are both confusing and fascinating.
I don't know if I should respond to Davey Do or Silverbells or maybe Daveybells or Silver Do.
If you want to be a no-code, that's your decision and I have no problem with it. What I do have a problem with is the position you are trying to put your colleagues in. They are not your nurses, they do not have your signed DNR and again even if they did, they have no way to know that it is the most current. What you TELL them doesn't matter, it legally doesn't add up to a hill of beans. If you code, they will start BLS and call 911. They would have to be stupid if they didn't, as they would be leaving themselves open to alot of professional and legal difficulties. That's the bottom line.
24 minutes ago, dream'n said:
Even if someone had a DNR tattoo, how could you defend yourself for NOT doing CPR if it ended up in court or before the Board? You don't know the person, maybe the tattoo is 20 years old and they had changed their mind but couldn't afford to remove it. Maybe they aren't competent, maybe it was a drunk joke, maybe it meant Da** No Regrets. Unless you are their nurse and have the DNR order, you better start BLS and call 911.
I would not wish for my coworkers to be reported to any board due to respecting my wishes. Are we absolutely sure there would no way be to assure them no BLS is the right option? Would save a lot of time and effort on their part If we could establish the legal logistics
I have no idea what my coworkers DNR status is and I find it a rather private decision I wouldn't want to discuss with them. Certainly some people may be comfortable sharing this with coworkers and that's fine. But if you were my coworker, it wouldn't matter what you SAID, you're not my patient and I don't have your DNR paperwork (and even if I did which is strange, I wouldn't know that it was the most current), therefore resuscitation would begin. I find it strange to worry (especially as your healthy) that you'll code at work and your coworkers would initiate BLS.
My first husband died of a stroke while he was in nursing school. He was 30.
I am now 43, and I am going to get a DNR signed.
Heres the difference between your ideas on this and mine, e.g. someone who prefers to have a DNR order.
For you, the standard of care is automatically EXACTLY what you want. You want CPR. You have no problem with it. Your coworkers are well aware of how to temporarily win what we often call "The argument with God," but most of these people will die soon anyways. Hence why I want a DNR. It's for the same reasons I got the covid vaccine. Quality of life is a higher priority to me, than quantity. I do not want to be laid up for the last days weeks or even hours of my life, in severe discomfort from fractured or even bruised ribs, in addition to the chest pain from having my heart fail.
I just don't like that idea, at all. It's not for me.
So, when I do get my DNR done, I am going to have a few copies of it made up. If I work in a facility, I can post it as a PSA next to the time clock. My DNR status is AS important to ME as YOUR full code status is to you.
I will post a copy of it on my home fridge as well, and I may even keep a laminated copy in my car.
My DNR status simply cant be honored unless everyone is already aware of it.
To me, its not a privacy issue. Im not sharing anything exceptionally personal. Im sharing this yellow form that essentially says "If I die, please don't fight it! Let me just be dead."
Because THAT, AGAIN, is super important to ME. It just doesnt happen to be the standard of care that all these overly hopeful full codes, want or expect.
So when you say it is a "personal matter" I mean, LMAO no its NOT. Not when the expected standard of care for me, is asking people to do the opposite of whats directed by law! Heck no. I wouldnt be keeping that private at all. I want everyone to know. Everyone.
Just clarifying. You seem pretty reasonably clued in so I thought I might help the cause a little. Haha most people die of undiagnosed Afib, anyways.
The only "enforceable" DNR (outside of a facility) is the hardcopy paper the doctor signed. I do have a drawing for a nifty tattoo that reads "DNR" no matter how you look at it that I plan to have inked on my sternum when that time f life approaches ?
I think a tattoo is a fine starting point, for helping someone to locate your up to date signed DNR form, which is literally the only thing that will protect THEM from legal issues.
Also the medical bracelet is also a good idea. I would simply add to the enscription, where to find the document that allows them to let you just be dead. LOL and IDK why people get so bajiggity over DNRs anyways. It's not like CPR is a guarantee that your heart will restart hahaha Christ, it only results in a live discharge 10% of the time, on average!! Even with the best Blue team, thats the BEST one can hope for. So its DNR ALL THE WAY for me lmao
I would not wish for my coworkers to be reported to any board due to respecting my wishes. Are we absolutely sure there would no way be to assure them no BLS is the right option? Would save a lot of time and effort on their part If we could establish the legal logistics
Yes. I have a looong post above. Just post your DNR form next to the time clock. Salaried employee? Tape your DNR form close to where you work, I.e. on the inside of your office door, on your cubicle wall, or wear a medical alert bracelet and carry a legally recognized DNR card in your wallet.
If you are committed to not wanting to be resuscitsted, you won't have any issues with telling everyone you know where to look for the documents, in the moments following whatever is causing your death.
If you want to be a no-code, that's your decision and I have no problem with it. What I do have a problem with is the position you are trying to put your colleagues in. They are not your nurses, they do not have your signed DNR and again even if they did, they have no way to know that it is the most current. What you TELL them doesn't matter, it legally doesn't add up to a hill of beans. If you code, they will start BLS and call 911. They would have to be stupid if they didn't, as they would be leaving themselves open to alot of professional and legal difficulties. That's the bottom line.
Again, the bottom line is the reasonable person standard, and of course, adequate documentation to defend not providing BLS.
The reasonable person with a DNR, can have their DNR posted above their bed and not think to bring their forms to work.
Thus, its on THEM, that they failed to provide adequate documentation, of their wishes, and no matter how much they TELL people they are a DNR, it really won't amount to them not getting BLS.
However, if they are vocal about their opposition to wanting heroic measures taken, AND they offer and inform their coworkers of the location of their DNR form, which must be kept recent and in a conspicuous place (I.e. next to the time clock, or on the inside of their office door, cubicle, wallet, etc) then there is absolutely NO reason why their coworkers should FAIL to recognize that they are INDEED providing plenty of advance directive to DNR.
Thats what the term advance directive means. The reasonable person standard applies, as well. If a person sees a signed DNR on their door, and ANYONE has been informed of their desire to be a DNR, then don't RESUSCITATE THEM.
Unless I am your DPOA and have your Living Will in my scrub pocket..
you can bet your sweet tookas you will be coded.
Again. If a person is a DNR they will have documentation of this, and will make people aware. You have a responsibility to that person to check for the DNR form, especially if they already told you it exists and where it is located, prior to their death.
If you don't abide, and their DNR is taped to the board next to the time clock, and most other people are well aware of their DNR status, unless you don't know that persons name, are blind, or have some other affirmative defense, I can assure you that this person or their family can indeed sue you for causing them unwanted and undue pain and suffering from broken ribs, and being kept alive while they should have been allowed to die.
This is called the reasonable person standard. IDK why yall have to be so gung ho about playing the hero, for someone who CLEARLY AND LEGALLY has shown any other reasonable person, that they do not want this level of care.
But.. no form, no problem. BLS the heck out of them. Thats their bad.
You picked the wrong field to work in if you don't want to be resuscitated. But, if you really don't want to be resuscitated, you should avoid dying at work.
You picked the wrong field to work in if you don't want to be resuscitated. But, if you really don't want to be resuscitated, you should avoid dying at work.
Why am I in the wrong field if I do not wish for CPR? Must all nurses maintain a Full Code status? Seems silly to me. I just don’t want coworkers wasting their time with CPR should something happen. If I’m gone, I’m gone.
9 hours ago, Gillyboo said:
Again, the bottom line is the reasonable person standard, and of course, adequate documentation to defend not providing BLS.
The reasonable person with a DNR, can have their DNR posted above their bed and not think to bring their forms to work.
Thus, its on THEM, that they failed to provide adequate documentation, of their wishes, and no matter how much they TELL people they are a DNR, it really won't amount to them not getting BLS.
However, if they are vocal about their opposition to wanting heroic measures taken, AND they offer and inform their coworkers of the location of their DNR form, which must be kept recent and in a conspicuous place (I.e. next to the time clock, or on the inside of their office door, cubicle, wallet, etc) then there is absolutely NO reason why their coworkers should FAIL to recognize that they are INDEED providing plenty of advance directive to DNR.
Thats what the term advance directive means. The reasonable person standard applies, as well. If a person sees a signed DNR on their door, and ANYONE has been informed of their desire to be a DNR, then don't RESUSCITATE THEM.
You picked the wrong field to work in if you don't want to be resuscitated. But, if you really don't want to be resuscitated, you should avoid dying at work.
If you did BLS on me after I have informed you and most other people of my DNR and posted that legal document near the time clock etc, you would be guilty of battery. And sued.
Do you force feed your patients too?
Honestly.I hate to break it to you, but Battery is illegal. You have no right to impose your personal wishes onto anyone else.
cardiacfreak, ADN
742 Posts
I don't know if I should respond to Davey Do or Silverbells or maybe Daveybells or Silver Do.