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?
First off, I wouldn't call people "moron", it's not appropriate; you put a DNR on a lanyard and expect people to check it, it' s unrealistic. Pick a medical proxy and just make sure that your DNR status is reported officially, not on a lanyard.
You can also pay for your own funeral in advance, they have programs for that and cremation is pretty cheap compared to a regular funeral. The same can be done for your bills (if you're that worried about the electric bill). You can set money aside for that. Consult an attorney for a will.
Additionally, this is not about funeral planning.
Funeral planning is a whole other topic.
This is about a lanyard being moved away from the area where compressions would take place, and having coworkers flip the darn thing over to see that VOILA! An official, state recognized portable DNR is indeed right there.
SilverBells makes a good point, and that point is well received.
Some people are obviously just not respectful of other peoples wishes. Wow.
Youre gonna move that ID/ pulse oximeter lanyard anyways. Is it really asking too much of you, to merely take a glance at the opposite side?
Why is this SUCH an issue for some of you?
I think its safe to say that short of being a known inpatient, with a DNR posted above the bed (which is really how this should be done, for admitted patients) that some of you literally are too ignorant to be capable of bothering to check ONE thing that is BEING MOVED and TOUCHED, ANYWAYS, and takes all of half a second (call 911 OK move this- nope no yellow seen there, lets start compressions) to look.
Its GREATLY DISAPPOINTING AND DISHEARTENING to hear SO MANY experienced and long term career nurses just be so FLIPPANT about legally binding forms.
And yes. A DNR next to the time clock works JUST FINE in making ones DNR status known to even unknown coworkers and temps, because everyone wears a flipping NAME TAG and USES THE SAME TIME CLOCK.
For salaried employees, the time clock may or may not be used. In the event that salaried employees don't use a time clock, its STILL just a matter of looking for yellow while moving that ID badge or lanyard, as this portable DNR IS reasonably in plain sight. It's just, it's not rocket science. It's a DNR and the person having and exercising the right to refuse, NOT being respected. THAT is the issue. To be clear.
What state are you all in? Lets explore each of you dissenters state rules and I think we can maybe find some way to help you to understand YOUR states laws on portable DNRs since Im really not sure you do.
And please stop it with the funeral planning.
My family will do that, AFTER they are called and informed I am dead. That has NOTHING to do with DNR forms. LOL wth man. Way to red herring your way through this thread though.
Additionally, how is a medical proxy going to help me NOT get resuscitated by a nurse that doesnt even respect my official, Dr ordered, portable DNR??!
all you are going to say to THEM is obviously "Until you get that document I have to give BLS."
Medical proxies probably arent going to keep that document in their own purses or wallets etc, much less putting it in their pockets every day at work. Also maybe that person is on vacation or working a different shift. How do they come to your aid then? Pssh you will respect only a living breathing person but not the wishes of a dead person with an ORDER hanging around their neck in the form of public signage.
Im so outraged at so many people on here right now, its unbelievable.
Oh and medical professionals in MY state (If you are ever in Florida) are indeed REQUIRED to honor a DNR, including a portable one, as long as its completed and printed on yellow paper. .
I had 8 years of sickness as a child from a birth defect. I also, prior to my current healthy and happy marriage, had 20 years of domestic violence, service related trauma, and rapes, ad nauseum.
Those are not my reasons for signing a DNR.
See, while I am a relatively healthy person, I am also cognizant of the chances being taken by receiving BLS. Chances are, I would die a day or two later, ANYWAYS. I would just have to additionally endure the pain of loosened and broken ribs, in addition to the pain of having my heart stop. I would also HATE the thought of being on life support.
You have had quite a lot of painful trauma in your life. Possibly there is a better outlet for exploring this worrysome, emotional stress with some one who can diagnose if you have PSTD. This is meant in a kind way where I see you have put considerable thought and energy into this emotional fear.
You have had quite a lot of painful trauma in your life. Possibly there is a better outlet for exploring this worrysome, emotional stress with some one who can diagnose if you have PSTD. This is meant in a kind way where I see you have put considerable thought and energy into this emotional fear.
I had therapy and no longer have PTSD symptoms.
This isn't about mental health.
Its about respecting decisions that are made between myself and my DOCTOR.
And all you have to do is respect them and also not be emotionally abusive in insinuating that some middle aged lady must be crazy for wanting a DNR.
YOU ARE NOT ALWAYS GOING TO AGREE WITH OTHER PEOPLES REASONS FOR REFUSING CARE, BUT YOU DAMN SURE BETTER RESPECT THEIR LEGALLY BINDING REFUSAL.
Again. I am wholly disgusted. I don't care now that you added some sugar at the end of that vitriolic, abusive drivel.
And frankly, I may not agree with some of your personal choices either, but that doesnt give me the inherent right to remove your ability to choose.
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
@Gillyboo I don’t think a single person on this thread has stated they would ever blatantly disregard a legal DNR paper. The question comes down to actually accessing the DNR paper, and many agreed that there needs to be better ways for a known DNR to be accessible in a non-hospitalized person.
I’m not sure about your facility, but in mine the nurses have a dozen plus different things hanging from their lanyards. Now if standard protocol in the facility or state were to have your personal DNR card at the very back as the last card, then I could see how it could be reasonable to have people flip a lanyard over before starting compressions. However I personally don’t know of any facility like this. Likewise I think hanging DNR papers of coworkers at the time clock is inappropriate and ineffective. Nobody is going to be running to a time clock to see if their coworker is one of the papers posted. Think of how many things are posted in break rooms and bathrooms that don’t get read.
Again I don’t think anyone is disagreeing with you that DNR should be respected. But this thread has shown that work needs to be done at facilities and on a state level to provide a more standard and easily accessible way to make that code status known when you aren’t admitted as a patient.
Your passion is clearly there. Your delivery, especially these last few posts you rapid fired, is not helping your cause at all and was rude and unnecessary.
I mean, and why would a DNR patient even have an ambulance called in the first place? They clearly don't need or want a paramedic. But okay.
Don't judge others by your twisted logic Gillyboo. Maybe the patient is 80 and the spouse can't get him into the car alone, family life in another city. He has lung cancer which is stable but he broke his leg, or has a UTI. You damn him to death because of some twisted knowlege you have about DNR.
I wrote kindly to you because even though you say you have had treatment/counseling for PSTD you are so angry I cannot think you have restful sleep or a good day. If many of us have identified your annoyance or hostility you have some residual anger that is impairing any kind of enjoyment of life besides trying to make sure no one codes them.
I do wish you joy in life or at least a happy day. It is not uncalled for sweetness. You need some help to enhance your life.
I am a in a helping profession and help others. you do not know the meaning of these words. There truly is hope in your future if you seek an emotional helper.
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
On 4/9/2021 at 2:15 PM, Gillyboo said:
I mean, and why would a DNR patient even have an ambulance called in the first place? They clearly don't need or want a paramedic.
This is a limited view of thinking, and your anger appears to be giving you some tunnel vision. My mother had a DNR and in home hospice as she was dying of metastasized breast cancer which included many pulmonary and cardiac complications. She made my stepdad call 911 one morning when she felt like she was suffocating while trying to breathe, even though she was very adamant about her DNR. There are many reasons someone with a DNR would call an ambulance so it’s ignorant to say anyone with a DNR doesn’t “need or want a paramedic.”
Specializes in OR, Nursing Professional Development.
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...... Again I don’t think anyone is disagreeing with you that DNR should be respected. But this thread has shown that work needs to be done at facilities and on a state level to provide a more standard and easily accessible way to make that code status known when you aren’t admitted as a patient.
This paragraph is pretty much the basis of this whole post. Nobody disputes honoring a DNR, only commenting just how hard it is know what somebody wants AT THE TIME OF AN ACTUAL EMERGENCY. My mantra in nsg all these years has been 'WHEN IN DOUBT, ERR ON THE SAFE SIDE'. This means I will initiate resusi care.
Don't judge others by your twisted logic Gillyboo. Maybe the patient is 80 and the spouse can't get him into the car alone, family life in another city. He has lung cancer which is stable but he broke his leg, or has a UTI. You damn him to death because of some twisted knowlege you have about DNR.
I wrote kindly to you because even though you say you have had treatment/counseling for PSTD you are so angry I cannot think you have restful sleep or a good day. If many of us have identified your annoyance or hostility you have some residual anger that is impairing any kind of enjoyment of life besides trying to make sure no one codes them.
I do wish you joy in life or at least a happy day. It is not uncalled for sweetness. You need some help to enhance your life.
No. You are twisting it all around as usual. Someone used the example of their mom having a DNR and having metastatic breast cancer who had difficulty breathing, and their entire mentality is apparently that her asking her family to call for rescue is somehow a means of justifying negating the DNR order.
You want to twist it. Not me.
Furthermore, yes clearly many people here do not understand the reasonable person standard, nor do they give a rats patootie about their own loved ones advanced directives, unless we too have a DNR, and have some respect for their wishes, so obviously the answer to Silver Bells question is a heart dropping hard NO from the rest of you. Would you respect ANYONES CLEARLY POSTED OFFICIAL DNR that wasnt lying in a hospital bed?
Clearly the answer is no.
The difference between you and me, is that I have respect for people's advance directives.
There is obviously a great divide here and Im sorry you are entirely missing the point, but thats obviously a problem too.
Surfin USA
105 Posts
Additionally, this is not about funeral planning.
Funeral planning is a whole other topic.
This is about a lanyard being moved away from the area where compressions would take place, and having coworkers flip the darn thing over to see that VOILA! An official, state recognized portable DNR is indeed right there.
SilverBells makes a good point, and that point is well received.
Some people are obviously just not respectful of other peoples wishes. Wow.
Youre gonna move that ID/ pulse oximeter lanyard anyways. Is it really asking too much of you, to merely take a glance at the opposite side?
Why is this SUCH an issue for some of you?
I think its safe to say that short of being a known inpatient, with a DNR posted above the bed (which is really how this should be done, for admitted patients) that some of you literally are too ignorant to be capable of bothering to check ONE thing that is BEING MOVED and TOUCHED, ANYWAYS, and takes all of half a second (call 911 OK move this- nope no yellow seen there, lets start compressions) to look.
Its GREATLY DISAPPOINTING AND DISHEARTENING to hear SO MANY experienced and long term career nurses just be so FLIPPANT about legally binding forms.
And yes. A DNR next to the time clock works JUST FINE in making ones DNR status known to even unknown coworkers and temps, because everyone wears a flipping NAME TAG and USES THE SAME TIME CLOCK.
For salaried employees, the time clock may or may not be used. In the event that salaried employees don't use a time clock, its STILL just a matter of looking for yellow while moving that ID badge or lanyard, as this portable DNR IS reasonably in plain sight. It's just, it's not rocket science. It's a DNR and the person having and exercising the right to refuse, NOT being respected. THAT is the issue. To be clear.
What state are you all in? Lets explore each of you dissenters state rules and I think we can maybe find some way to help you to understand YOUR states laws on portable DNRs since Im really not sure you do.
And please stop it with the funeral planning.
My family will do that, AFTER they are called and informed I am dead. That has NOTHING to do with DNR forms. LOL wth man. Way to red herring your way through this thread though.