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?
..... Think about this: We might not agree with a patient spending all day in bed as it promotes bowel problems and the risks for pressure wounds. But unless that patient is motivated to get out of bed, there’s not a whole lot we can do. We might not agree with this, but unfortunately we have to respect that a patient is choosing to be non compliant
But why is this getting YOUR panties in a twist??!!??
But why is this getting YOUR panties in a twist??!!??
Confused. I was simply providing an example of how we don't always have to agree with someone else's choices in order to respect them. Obviously staying in bed all day is not in a patient’s best interest, but unfortunately nurses all the time have to respect their noncompliance
This thread really isn’t meant to be argumentative. More so: How can we respect the individual needs of each and every individual in a way that aligns with their goals of care?
Confused. I was simply providing an example of how we don't always have to agree with someone else's choices in order to respect them. Obviously staying in bed all day is not in a patient’s best interest, but unfortunately nurses all the time have to respect their noncompliance
Oh. Now it's non-compliance? I thought it was an end of life decision? Which is it??
This thread really isn’t meant to be argumentative. More so: How can we respect the individual needs of each and every individual in a way that aligns with their goals of care?
Give it up. I feel like the waters have been irreparably muddied here and even made the gut-wrenching life decisions of whether or not to choose DNR/DNI or life saving procedures is being minimized and not taken as seriously as decisions like this deserve.
Quit projecting your obviously deeply rooted pain about life onto others. I will now join the choir and say, SEEK HELP.
Give it up. I feel like the waters have been irreparably muddied here and even made the gut-wrenching life decisions of whether or not to choose DNR/DNI or life saving procedures is being minimized and not taken as seriously as decisions like this deserve.
Quit projecting your obviously deeply rooted pain about life onto others. I will now join the choir and say, SEEK HELP.
Peace out, love. I wish you the best.
This thread is not meant to make light of anything. The topic, as you know, is serious and requires consideration. As such, the goal of this thread really is to discuss: How do we respect and honor everyone’s health care wishes in a way that meets their needs and goals of care? Not sure what is wrong with that.
I've never thought I would find myself saying this, but I don't think SilverBells is the unreasonable one in this discussion.
While SilverBells is no doubt odd, and for all I know may even be found to have a personality disorder or two, he or she is a long way from being incompetent to make medical decisions. And declining a surgery, even if you would find agreeing to surgery a no-brainer when it comes to yourself, is not a basis for declaring someone incompetent to make medical decisions.
The idea that someone choosing to be DNR is unfair to medical professionals because they would then be unable to subject them to medical treatments they feel they should have is absurdly self-centered.
The choice to be DNR is by no means limited to "terminal" patients, whether or not it's a choice you would make is not what makes it an unreasonable choice, only the individual making the choice can determine that.
To be honest, when the thread started I thought the premise was a bit silly, but I thought that because what decent person wouldn't recognize another person's decisions about what they want done.
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.
No, no, no.
If you needed intubation, during surgery, great get intubated. Totally not the same thing as being resuscitated from death.. although, a person could indeed include a DNI along with their DNR.
Just because a physician thinks its better to intubate you, doesnt mean its going to be allowed. It's actually something that physicians will kindly consider asking you, prior to surgery. It's LITERALLY ALL YOUR OWN CHOICE.
And yes. If a DNR had a freak accident AND DIED from that accident, then do not resuscitate.
The reasons for the death are not important. The persons choice of what medical care they want or don't want, IS.
This entire thread is about RESPECTING another person's DNR. If they arent dead, take care of them. If they ARE dead, do the right thing as they ask, and let them die naturally, by NOT trying to resuscitate them.
amoLucia
7,736 Posts
But why is this getting YOUR panties in a twist??!!??