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?
Specializes in Pedi; Geriatrics; office; Pedi home care..
Perhaps have a TATOO on your inner forearm DNR/DNI? (Had friend who was allergic to ASA; she had it tattooed in red ink on her forearm. Saved her from reaction when she had an MI.)
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
25 minutes ago, Allgood2016 said:
Perhaps have a TATOO on your inner forearm DNR/DNI? (Had friend who was allergic to ASA; she had it tattooed in red ink on her forearm. Saved her from reaction when she had an MI.)
The problem is a tattoo isn’t a legal form of DNR, so that wouldn’t work. Maybe if the tattoo said “check my lanyard for my DNR” LOL.
Perhaps have a TATOO on your inner forearm DNR/DNI? (Had friend who was allergic to ASA; she had it tattooed in red ink on her forearm. Saved her from reaction when she had an MI.)
34 minutes ago, JadedCPN said:
The problem is a tattoo isn’t a legal form of DNR, so that wouldn’t work. Maybe if the tattoo said “check my lanyard for my DNR” LOL.
State laws vary somewhat widely about what works as a DNR, who can recognize it as a DNR, and where, but in my state a Tattoo has been added as a legally defined indicator of a POLST, along with DNR bracelets and necklaces. There is information it must contain, and only directs non-Physician staff to the presence of a POLST, but a physician can recognize it as a stand-alone DNR.
And on the ASA allergy tangent, we still give aspirin to those who report an ASA allergy in the case of emergent PCI along with a rapid desensitization protocol.
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
2 minutes ago, MunoRN said:
State laws vary somewhat widely about what works as a DNR, who can recognize it as a DNR, and where, but in my state a Tattoo has been added as a legally defined indicator of a POLST, along with DNR bracelets and necklaces. There is information it must contain, and only directs non-Physician staff to the presence of a POLST, but a physician can recognize it as a stand-alone DNR.
And on the ASA allergy tangent, we still give aspirin to those who report an ASA allergy in the case of emergent PCI along with a rapid desensitization protocol.
Thank you for the information! I would never have imagined a tattoo would be legally recognized but I can see why it would make sense too. In addition to the specific information it must contain, can I assume it has to be tattooed in a specific/designated area?
Thank you for the information! I would never have imagined a tattoo would be legally recognized but I can see why it would make sense too. In addition to the specific information it must contain, can I assume it has to be tattooed in a specific/designated area?
The example they give is of a tattoo on the chest, but it doesn't appear to differentiate based on location.
It actually wasn't a huge change when it became 'official', physicians have always had the leeway, at least in this state, to consider any overt declaration of EOL wishes as being sufficient for medical decision making.
The addition of tattoos was added to the state statute supposedly because of a case of a patient I was familiar with, although the example doesn't really include the full complexity of it. But basically the gist was that a physician should determine the level of care the patient is consented to based on the available information, if there is no clear information that they want everything done, but they've gone through the fairly severe effort of getting a DNR tattoo, then there isn't any good reason to assume they want aggressive things done to them, at that point you're venturing into assault or at least assault-adjacent territory.
Its about RESPECT. NOT YOU. NOT YOU NOT YOU NOT YOU.
There you go. It's not about you, indeed. Don't ask your coworkers to feed into your "end of life wishes" grand plan dangling from a dirty lanyard. They are there to work, not to worry about your code status.
amoLucia
7,736 Posts
That was one VERY COOL TV show! All the characters were funny as h*ll.
Best episode was the one where Herb arranged for frozen turkeys to be dropped from an airplane as some station promo. FROZE TURKEY BOMBS!
But back to this post's topic - where do I get a portable DNR card for a lanyard??? Amazon has lanyards ....