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?
Silver - I think this poster was just being a bit sarcastic and over the top. I think you missed it! And took the comment literally.
hhernn - what's ROSC?
Actually, I did mean it literally.
When it comes to healthcare, all I really know is the hospital. And, when it comes to outpatient codes, the chance of anybody verifying a code status before it is too late- one way or another- is slim. unless this SCA happens in your own unit, with people who know you and your wishes, and don't call a code.
As far as the card around the neck? I suppose it's possible somebody will see and understand it. I wouldn't count on it. People get pretty amped up when, in the middle of a shift, a coworker up and dies.
A guy comes into the ER, with a complaint of abdominal pain. He is in the process of telling the doc he feels silly for coming in, as the pain is mostly gone. Goes into a V-fib arrest. Compressions while we are hooking him up, 1 shock, and we get him back. Turns out he was DNR. I had him later in the ICU, asked him how he felt about it. Turns out, given his full recovery, he was OK with it. Good thing, as there was no way I could take it back any way.
Unfortunately, in the ER we periodically work DNRs. The reality is that whether in the field, or in the ER, when somebody casts doubt on the DNR, we err toward working it. And, nobody I work with believes in the "slow code". So, regardless of our beliefs, we do our job well. Most of those who regain ROSC do not have a meaningful recovery. Some linger in an ICU, and some are let go once the status is sorted out.
No doubt a crappy system.
Specializes in Community Health, Med/Surg, ICU Stepdown.
@Davey Do are you really behind the sensational @SilverBells posts? I can't tell if you're joking! Maybe I'm gullible. Like others I was starting to wonder if it was all a joke, but at first I really was concerned it was a real person who was reaching out to the internet due to lack of other supports. As someone who has experienced mental health crises, I felt compelled to reach out.
If it was a all a joke, it still stimulated some interesting conversations! You have pulled off a great internet scheme LOL but if this person is fake I do feel a bit frustrated about spending time trying to help someone who doesn't exist. But, I brought it on myself; I didn't have to respond or read. Good reminder to focus my attention on real life friends. Quarantine increased the time I spend online due to not being able to see people in person, but now I will try harder to set up phone calls and Zooms with people. = ) Maybe we could have talked about fun topics like housing, absurd vending machine habits (even if invented), internet stalking, and online dating without making people worry about a fake person's mental health. Again, not mad! Just ashamed for falling for it and wasting my time = (
Specializes in Community Health, Med/Surg, ICU Stepdown.
3 minutes ago, Davey Do said:
I am on my smartphone, but felt compelled to reach out to you LibraNurse.
No, I am not SilverBells.
I am not that good of an actor.
LOL! Oh man, you are good!! I knew you wouldn't do me like that @Davey Do, and if you did, couldn't stay mad at you anyway. Wouldn't have put it past you because your threads and cartoons ARE very creative! ? Thank you for responding!
Libra - you forgot the topics of material wealth envy, unfulfilled job aspirations, end of life decisions for the young & healthy.
Wasn't the first topic some time back when the OP couldn't/wouldn't stop visiting another unit's LOL pt. She would do extended personal care, incl foot massages b/c she felt the other staff weren't doing enough.
Specializes in Community Health, Med/Surg, ICU Stepdown.
24 minutes ago, amoLucia said:
Libra - you forgot the topics of material wealth envy, unfulfilled job aspirations, end of life decisions for the young & healthy.
Wasn't the first topic some time back when the OP couldn't/wouldn't stop visiting another unit's LOL pt. She would do extended personal care, incl foot massages b/c she felt the other staff weren't doing enough.
Yes! I think the posts resonate with people because they are common feelings but taken to the extreme. I also have material wealth aspirations, want to be a DNR, and like to go above and beyond for my patients, but try not to let those things get out of control.
I visited my step-down pts when they got transferred to the floor. I brought food for my long haul covid pts trapped in isolation room for 3 months and experiencing "fish Friday" 12 times in a row... yuck! But no 2 hr foot massages LOL. I am not the one behind the SilverBells posts, I swear! Just a less exciting, muted version = ( Maybe it's the soda and sugar that takes it up a notch LOL no offense intended @SilverBells! That thread was so fun
28 minutes ago, Curious1997 said:
I can't believe that anyone fell for it. Your styles are so different and distinctive!
I told you I was gullible! You're just lucky I didn't believe covid was a hoax... kind of hard while working on a covid unit ? JK I have no belief in our former President Orange Cheeto Man's conspiracy theories. ALL offense intended @TheRealDonaldTrump. Oh wait, he is kicked off all social media, even Pinterest and allnurses!!
Additionally, in my state, anyways, there is a DNR form that can also be laminated and worn around the neck, and the reasonable person standard is to presume that as long as I am wearing it, YOU keep YOUR HANDS OFF OF ME.
... In addition, when the DNRO is presented to an emergency medical technician or paramedic in a setting other than a health care facility, the form may be honored [emphasis added]. ...
This is also included in the PDF file you attached.
Specializes in Psych (25 years), Medical (15 years).
1 hour ago, LibraNurse27 said:
LOL! Oh man, you are good!! I knew you wouldn't do me like that Davey Do, and if you did, couldn't stay mad at you anyway. Wouldn't have put it past you because your threads and cartoons ARE very creative! Thank you for responding!
You are so welcome, LibraNurse, and thank you for the kind words.
The idea to become SilverBells came to me as I was reading the many not-so-nice posts in her threads. I thought, "What if SilverBells is like my old brother-in-arms coworker/friend psych tech Rooty Payne?" Rooty Payne's acting abilities equal that of one of my favorite famous actors, Denzel Washington.
I have a virtual plethora of stories about Rooty's many acting roles, but would like to relate one that was a turning point in our relationship:
One night years ago, a hard working, easy-going nursing student, Matt, was working geriatric psych with Rooty and me. At one point, Matt had a rather franic look on his face and I asked him what was wrong. Matt said he had lost track of his keys, which included a key to the locked unit and another inside doors key. We retraced his steps and looked everywhere to no avail.
I thought, "You know, Rooty is rather mischievous, so if Matt left his keys lying around, Rooty might just snatch them up in order to teach Matt a lesson".
Matt continued to frantically search for his keys. Rooty was sitting on a 1:1, so I walked down the hall and said, verbatim, "Rooty, you know I respect you professionally, and personally, I like you."
Rooty cocked his head and looked at me with a puzzled expression on his face, and I continued, "Did you take Matt's keys?" Rooty's face became one of hurt and anger. I thought, "Oh no. I've hurt and insulted Rooty. Our relationship will never be the same positive one it was".
To make a very long story short, Rooty eventually spilled the beans that he had taken Matt's keys, and I hid them in a place where Matt eventually found them.
What if SilverBells has Rooty's acting abilities, is really a relatively together person, and is merely acting a part?
So, I became SilverBells and got to read some really interesting responses!
1 hour ago, Curious1997 said:
I can't believe that anyone fell for it. Your styles are so different and distinctive!
Guest219794
2,453 Posts
Actually, I did mean it literally.
When it comes to healthcare, all I really know is the hospital. And, when it comes to outpatient codes, the chance of anybody verifying a code status before it is too late- one way or another- is slim. unless this SCA happens in your own unit, with people who know you and your wishes, and don't call a code.
As far as the card around the neck? I suppose it's possible somebody will see and understand it. I wouldn't count on it. People get pretty amped up when, in the middle of a shift, a coworker up and dies.