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?
I have a lot more faith in preventative and comfort care, than I will likely ever have in actual rehabilitative/ restorative treatments.
Im not against antibiotics. I have used them a million times. By the age of 8, I had probably had 100 or more antibiotic prescriptions.
I have all my vaccines, including COVID.
I've had a lot more surgeries than the average joe, and usually surgery is VERY helpful. So I do have a tremendous amount of faith in surgery.
CPR is a whole other animal. I actually think the people who WANT to be full codes are the crazy ones. The chances of being discharged alive are very slim, so its generally going to just reissue life where life should simply not be continued.
I kinda think of CPR as a money maker, because the reality is, it so rarely (10.6% of the time on average) results in a live discharge, that I believe its just a fantastic way to hospitalize people in the last day or two of their lives, and even longer for those who go brain dead and are put on life support.
I mean.. what life is there left to support? Life ended. Let it be natural and far less intrusive.
Thanks for answering my questions. I was trying to understand how far this ”breath of God” line of reasoning went. If I’ve understood your reply correctly you do think modern medicine has its uses.
I haven’t seen if you’ve included a source for the 10.6% statistic? It seems awfully low. I’m Scandinavian and when I checked the most recent available stats (2019) for my country, the out-of-hospital 30-day survival rate after CPR was 11%. For patients who had their cardiac arrest while they were hospitalized, the 30-day survival rate was 37%. The best part is that over 90% of both categories self-reported good quality of life during follow-up interviews.
Sometimes death is exactly as you say, natural. Other times, it’s not. I work trauma surgeries and I personally don’t find anything natural about a 22-year-old dying after having been stabbed in a drunken brawl. Or a 38-year-old parent of two, car accident victim. Or the 51-year-old domestic abuse victim. I’m quite happy when we manage to save these people and they can go on living their lives (the last example hopefully minus one utterly useless partner).
We have universal healthcare. Patients aren’t a source of revenue. We don’t make money by saving people if their hearts stop. They cost a lot more alive than dead. We can always use an extra bed. Yet, each and every time we insist on trying to save them when we have the ability to do so. Of course we’ll respect a patient’s legal advance directives but very few of our trauma patients coming in have one of those.
14 hours ago, Gillyboo said:
Death is NOT optional. It's GOING to happen to us all.
If that creeps you out, thats your issue. LOL
Of course it’s going to happen to all of us. Was that last part necessary in your opinion? I never said death creeps me out. But if it had, what possible purpose would your LOL have served?
Specializes in Community Health, Med/Surg, ICU Stepdown.
12 hours ago, macawake said:
I’m Scandinavian and when I checked the most recent available stats (2019) for my country, the out-of-hospital 30-day survival rate after CPR was 11%. For patients who had their cardiac arrest while they were hospitalized, the 30-day survival rate was 37%. The best part is that over 90% of both categories self-reported good quality of life during follow-up interviews.
Interesting! I always wonder about how many people really pop up from CPR totally fine like in Grey's Anatomy (I love how their patients "wake up" during chest compressions and then just sleep peacefully with beautiful hair and make up, no ET tube or monitors!) I've only seen one patient totally recover from a code with no brain or body damage at all, and she was one of the meanest pts I've ever had! LOL
I don't think you should stress so much about dying at work/DNR/funeral. It's doubtful you'll be able to get a DNR and if you do that someone will find it if you code somewhere other than a hospital. I also want to be a DNR if I am resuscitated and have no hope of regaining full brain function. I just make these wishes known to my family and partner and hope they carry out my wishes if something happens to me. Focusing so much on death is a sign of depression, so I do hope your counseling will help whenever it starts. Not judging, I've been depressed in the past and thought about death too.
So, considering that you are SO enjoying making fun of the thread, lets examine your own logic. Your claim is that you are DNR who wants to also be full code, because you think you are going to have a higher "quality of life" if rescued from a state of being actually dead?
When your heart stops and you are in respiratory arrest, you ARE unable to make decisions for yourself.
You have ZERO life, your life has terminated, therefore there wouldnt be any concern for your life's quality, since it has officially ended.
So maybe I, captain obvious, should invite everyone else to start popping some corn, and lets see how YOU find any logic whatsoever in that statement.
Because, honestly, maybe I am not understanding why you have a DNR if you are actually a full code.
Perhaps a medical proxy for situations where you would prefer to not be kept on life support etc, would be more ideal for your situation..
You have an advance medical directive, but an advance directive isn't necessarily a DNR.
So pop some popcorn and read your statute, before you come back here making snide and sarcastic remarks about other peoples actual DNR status. Sheesh.
So you skipped the disclaimer about having a terminal status and/or being in a condition with no chance of recovery to a fulfilling life? I'm not understanding why you're uptight about someone else's life decisions. Also not understanding why you're not understanding the popcorn thing is a means to lighten up the thread because some of you are clearly taking this DNR thing way too personal.
Interesting! I always wonder about how many people really pop up from CPR totally fine like in Grey's Anatomy (I love how their patients "wake up" during chest compressions and then just sleep peacefully with beautiful hair and make up, no ET tube or monitors!) I've only seen one patient totally recover from a code with no brain or body damage at all, and she was one of the meanest pts I've ever had! LOL
Specializes in Nurse Leader specializing in Labor & Delivery.
18 hours ago, macawake said:
Of course it’s going to happen to all of us. Was that last part necessary in your opinion? I never said death creeps me out. But if it had, what possible purpose would your LOL have served?
My sister does this in her communication too. It's a passive-aggressive communication tool. I hate hate hate when a person writes something aggressive or insulting, then writes "LOL" afterwards.
Specializes in Community Health, Med/Surg, ICU Stepdown.
4 hours ago, NurseBlaq said:
What's that saying? She was too mean to die.
Awww I didn’t mean it in a bad way! I just thought maybe her toughness helped her recover? It just kind of sucked because the code team responded so fast and effectively and she recovered so well, only to scream at us and physically attack people. But, I know she had issues that caused her to act out, and in the end she thanked us for “saving her life.” I’m sure having a near death experience scared her and caused a reaction.
Having behavior issues doesn’t mean someone deserves to die, of course not! Maybe I was hoping for a fairytale story LOL too idealistic at times
Awww I didn’t mean it in a bad way! I just thought maybe her toughness helped her recover? It just kind of sucked because the code team responded so fast and effectively and she recovered so well, only to scream at us and physically attack people. But, I know she had issues that caused her to act out, and in the end she thanked us for “saving her life.” I’m sure having a near death experience scared her and caused a reaction.
Having behavior issues doesn’t mean someone deserves to die, of course not! Maybe I was hoping for a fairytale story LOL too idealistic at times
No, that's really a saying. People are always saying someone is "too mean/evil to die". It's always meant as an LOL type thing, never malice. Well, not when I've heard it anyway.
Specializes in Community Health, Med/Surg, ICU Stepdown.
2 hours ago, NurseBlaq said:
No, that's really a saying. People are always saying someone is "too mean/evil to die". It's always meant as an LOL type thing, never malice. Well, not when I've heard it anyway.
Thanks for answering my questions. I was trying to understand how far this ”breath of God” line of reasoning went. If I’ve understood your reply correctly you do think modern medicine has its uses.
I haven’t seen if you’ve included a source for the 10.6% statistic? It seems awfully low. I’m Scandinavian and when I checked the most recent available stats (2019) for my country, the out-of-hospital 30-day survival rate after CPR was 11%. For patients who had their cardiac arrest while they were hospitalized, the 30-day survival rate was 37%. The best part is that over 90% of both categories self-reported good quality of life during follow-up interviews.
Sometimes death is exactly as you say, natural. Other times, it’s not. I work trauma surgeries and I personally don’t find anything natural about a 22-year-old dying after having been stabbed in a drunken brawl. Or a 38-year-old parent of two, car accident victim. Or the 51-year-old domestic abuse victim. I’m quite happy when we manage to save these people and they can go on living their lives (the last example hopefully minus one utterly useless partner).
We have universal healthcare. Patients aren’t a source of revenue. We don’t make money by saving people if their hearts stop. They cost a lot more alive than dead. We can always use an extra bed. Yet, each and every time we insist on trying to save them when we have the ability to do so. Of course we’ll respect a patient’s legal advance directives but very few of our trauma patients coming in have one of those.
Of course it’s going to happen to all of us. Was that last part necessary in your opinion? I never said death creeps me out. But if it had, what possible purpose would your LOL have served?
Scandinavia definitely has the US beat in health care. This was a US based study. Im sure I posted the link before. If you are interested, you are welcome to dig through and pick through it.
Norway and Sweden's health care systems are FAR superior to what is offered in the USA. We are actually ranked #37 in the world, only two spots higher than CUBA.
It sucks.
Rich people here go elsewhere for serious doctors. It's no joke.
Perhaps if we had more faith in our health care system, many here who are DNRs wouldnt be so quick to want to fill out that legal directive.
LOL... it just is what it is. It's systemic here. You cant fix it and neither can I. So why not have a laugh at the irony?
Oh and no, its not me being passive aggressive, saying LOL. It's images like popping popcorn which is really just a means of degrading other peoples beliefs and choices, down to a form of entertainment, while asking someone about their mental health, etc, simply to ACTUALLY be passive about their beliefs not being something they agree with, and not actually wanting any confrontation. When confrontation happens, they really hate it. To the extent that they snap and become aggressive. Meme posters are SO passive aggressive. I am assertive.
Sorry if MY use of "LOL" triggered some of you, but again. Thats a trigger. Not something directly related to me. Mm kayyyy
So you skipped the disclaimer about having a terminal status and/or being in a condition with no chance of recovery to a fulfilling life? I'm not understanding why you're uptight about someone else's life decisions. Also not understanding why you're not understanding the popcorn thing is a means to lighten up the thread because some of you are clearly taking this DNR thing way too personal.
Im not taking anyone's advance directive personally. Clearly I am a big proponent of DNR education and respecting others rights.
However, an advance directive isn't necessarily a DNR.
Clearly, this person (a nurse in this thread) wants to be a full code, and claims to also be a DNR, but cant seem to understand that wanting to he resuscitated at death is contradictive to a DNR status, particularly when their "quality of life" is certainly not going to improve, because... drumroll, please.. they are dead. Their life is over. It has ended. Terminated. Finito. Done. There is no quality to be concerned with.
A person who really signs a DNR, understands these merits as its most basic CORE principle.
So my question is this: Does he or she really have a dnr, or is this person, perhaps, very confused about DNRs in general.
Again, I want to help people to understand how all this works.
Thanks. A couple of things in mind: I could switch my PCP from one organization to another and see if that helps. I may also have to pick a health care proxy who does not know me quite as well since the people who know me best are not willing to help with any aspects of a DNR/DNI order.
Yeah I am really shocked that they are not adhering to helping you with your personal choices. You are clearly alert and oriented x 100 or whatever the max is. Sorry- LOL- I don't even do those assessments, Im not a nurse, obviously.
But yeah I do think finding a more respectful PCP is a fantastic idea. You may even complain about your old doctor not recognizing your right to make your own choices, to the board of medicine. I find it to be pretty reprehensible behavior on his part to flat out refuse you. It's also not up to your family/friends/community what your end of life choices should be. It's not for anybody on this message board to dictate either. It's YOUR choice. I for one, fully support it, and respect it, regardless of your reasoning. Your reasoning is as good as mine. It just allows you to die naturally. There should really be no shame or distress or harassment in you making that choice.
macawake, MSN
2,141 Posts
Thanks for answering my questions. I was trying to understand how far this ”breath of God” line of reasoning went. If I’ve understood your reply correctly you do think modern medicine has its uses.
I haven’t seen if you’ve included a source for the 10.6% statistic? It seems awfully low. I’m Scandinavian and when I checked the most recent available stats (2019) for my country, the out-of-hospital 30-day survival rate after CPR was 11%. For patients who had their cardiac arrest while they were hospitalized, the 30-day survival rate was 37%. The best part is that over 90% of both categories self-reported good quality of life during follow-up interviews.
Sometimes death is exactly as you say, natural. Other times, it’s not. I work trauma surgeries and I personally don’t find anything natural about a 22-year-old dying after having been stabbed in a drunken brawl. Or a 38-year-old parent of two, car accident victim. Or the 51-year-old domestic abuse victim. I’m quite happy when we manage to save these people and they can go on living their lives (the last example hopefully minus one utterly useless partner).
We have universal healthcare. Patients aren’t a source of revenue. We don’t make money by saving people if their hearts stop. They cost a lot more alive than dead. We can always use an extra bed. Yet, each and every time we insist on trying to save them when we have the ability to do so. Of course we’ll respect a patient’s legal advance directives but very few of our trauma patients coming in have one of those.
Of course it’s going to happen to all of us. Was that last part necessary in your opinion? I never said death creeps me out. But if it had, what possible purpose would your LOL have served?