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?
Does your conversation with the Physician get any more specific than that? There's certainly more familiarity with the issues surrounding resuscitation being a nurse, but I'm not sure that alone is enough to convey that you are making an informed refusal of a treatment.
Good grief. They are refusing to treat her because its obviously a bunch of pro lifer, anti choice people.
This is an actual THING, by the way. The problem with fringey pro lifers is that they seem to have a disconnect with reality. And the reality is, people die.
Not everyone wants to be resuscitated, or even have an attempt made, because its simply a matter of dying naturally. It's not about them thinking shes a nutjob who cant make her own informed decisions. They are oppressing her rights by refusing to be a witness on the paper that says "Just let me die naturally, everyone. Thats the way I CHOOSE to go."
Why do we have to put on a whole song and dance, to simply have the right to die naturally?
We are dead. don't try to bring us back to life. Thats all. It's simple.
You are correct, this is a strange topic. Your posts are worded in a way that are likely to elicit a strong emotional response in people who are empathetic. This is a forum for nurses and the chance that you’ll receive multiple replies on the theme of ”please get help”, ”you’re young and healthy and it’s sad to see that you want to be DNR” or ”you sound like you might be dealing with anxiety and depression” etc is very high. It’s probably one of the better forums to make posts like this if you’re looking for strong reactions.
If any, or all, of the thoughts you’ve described in numerous posts are feelings and thoughts that you actually have, then seek help. In real life.
At this point I have to wonder if Silver Bells is just trolling all of us.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
On 4/4/2021 at 4:42 PM, SilverBells said:
Curious as to how it would be unethical for a physician to sign DNR/DNI orders for a healthy 30 year old? My thinking is just as a 92-year old with 20+ diagnoses has the right to be a full code, a healthy 30-year-old should also have the right to be a DNR/DNI.
I'm not sure how this would be putting anyone in a horrible position. I would think it would actually make things easier for all to know that I do not wish to be resuscitated in any circumstances.
?
I don't think you really understand what a DNR/DNI is.
It doesn't mean that you won't be resuscitated or incubated under any circumstances. If you were at end of life you could have a POLST, which is a different thing.
A DNR doesn't apply if for example: you went under anesthesia to get your tubes tied and then you had a weird reaction and they had to intubate you. The people doing your tubal ligation don't have to be responsible for your death just because you'd like to be a DNR. You have rights and so does your surgeon.
Or in a freak accident. Let's say you slipped in some powerful poop on your unit, cracked your head on the vending machine that was devoid of sodas due to coworkers hoarding them and then a great horned people eating eagle swooped in through the open window on your unit and attacked you. The smarter nurse manager than you can't just be like... oh... girlfriend's a DNR. Just let the eagle eat her. Or wait... you can shoo the eagle out but no compressions for Bellsy.
Or in a freak accident. Let's say you slipped in some powerful poop on your unit, cracked your head on the vending machine that was devoid of sodas due to coworkers hoarding them and then a great horned people eating eagle swooped in through the open window on your unit and attacked you. The smarter nurse manager than you can't just be like... oh... girlfriend's a DNR. Just let the eagle eat her. Or wait... you can shoo the eagle out but no compressions for Bellsy.
No, no, no.
Que the rock n roll song, "Knockin' on Heaven's Door" by the heavy rock band, Guns N' Roses.
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.
So the thing is that there's difference between having one's wishes respected vs. expecting others' support when a person works to destroy themselves and then prefers the thought of everyone around them standing by with their hands preemptively tied behind their backs when they drop dead.
Please ^ read that neutrally...carefully. And see that it involves way more than just not wanting to be resuscitated at life's natural end, whenever that may be. And you are speaking within a group of people who have at least some minimal degree of training for recognizing that.
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
7 hours ago, FolksBtrippin said:
Or in a freak accident. Let's say you slipped in some powerful poop on your unit, cracked your head on the vending machine that was devoid of sodas due to coworkers hoarding them and then a great horned people eating eagle swooped in through the open window on your unit and attacked you. The smarter nurse manager than you can't just be like... oh... girlfriend's a DNR. Just let the eagle eat her. Or wait... you can shoo the eagle out but no compressions for Bellsy.
No, no, no.
This is possibly the greatest thing I’ve read in quite some time; let my wipe my tears of laughter away and give you a standing ovation (cue a @Davey Do animation). Thanks for starting my morning off right!
Specializes in OR, Nursing Professional Development.
8 hours ago, FolksBtrippin said:
A DNR doesn't apply if for example: you went under anesthesia to get your tubes tied and then you had a weird reaction and they had to intubate you. The people doing your tubal ligation don't have to be responsible for your death just because you'd like to be a DNR. You have rights and so does your surgeon.
That’s actually not a universal truth and actually a violation of patient autonomy. My facility includes on both the procedure consent and the anesthesia consent a section of checkboxes for continue DNR while in surgical/procedure units or rescind DNR while in surgical/procedure units. For those that rescind, the order is back in effect once they leave the post op area.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
4 minutes ago, Rose_Queen said:
That’s actually not a universal truth and actually a violation of patient autonomy. My facility includes on both the procedure consent and the anesthesia consent a section of checkboxes for continue DNR while in surgical/procedure units or rescind DNR while in surgical/procedure units. For those that rescind, the order is back in effect once they leave the post op area.
Interesting... that was not an option for my grandmother, and my mom (also an RN) kind of had a fit about it.
But I thought it was fair. I actually do not think it is a violation of patient autonomy.
If you die during surgery, and your team doesn't try to save you, I think that's wrong.
And I think if you're unwilling to let your team save your life if you code during a traumatic event they planned, then you aren't really appropriate to have the procedure done.
No medical professional should have to take that on.
Specializes in Psych (25 years), Medical (15 years).
8 hours ago, FolksBtrippin said:
Or in a freak accident. Let's say you slipped in some powerful poop on your unit, cracked your head on the vending machine that was devoid of sodas due to coworkers hoarding them and then a great horned people eating eagle swooped in through the open window on your unit and attacked you. The smarter nurse manager than you can't just be like... oh... girlfriend's a DNR. Just let the eagle eat her. Or wait... you can shoo the eagle out but no compressions for Bellsy.
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Surfin USA
105 Posts
Good grief. They are refusing to treat her because its obviously a bunch of pro lifer, anti choice people.
This is an actual THING, by the way. The problem with fringey pro lifers is that they seem to have a disconnect with reality. And the reality is, people die.
Not everyone wants to be resuscitated, or even have an attempt made, because its simply a matter of dying naturally. It's not about them thinking shes a nutjob who cant make her own informed decisions. They are oppressing her rights by refusing to be a witness on the paper that says "Just let me die naturally, everyone. Thats the way I CHOOSE to go."
Why do we have to put on a whole song and dance, to simply have the right to die naturally?
We are dead. don't try to bring us back to life. Thats all. It's simple.