Coworkers Respecting Each Others' Advance Directives and Code Statuses

[SilverBells]

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? 

[CABGpatch_RN, BSN]

4 minutes ago, SilverBells said:

Sorry.  I have no problems reiterating what I said.  The post was meant as an apology for not acknowledging other viewpoints and that there are a wide range of reasons in which a DNR/DNI or refusing medical care would not be appropriate.  I deleted it for the time being as it seemed to repeat itself over and over again and wasn’t worded correctly, or not in a way that would make sense.  I have no issues admitting that I am wrong.  Clearly, I’ve been wrong a lot lately, so wanting to take more time before posting. With that said, I’m sorry for your feelings and do apologize 

Oh and remember, the last sustenance of your post, you said something like (paraphrased), and yes, I'm in a good mood today with a smiley face emoji?

An what you write above is NOT how you worded that post.  YOU will NOT fool me.  Your manipulative ways need to be seen by everyone.  You are not a sweet innocent, my dear.

I don't need you to be sorry for my feelings.  My feeling have ZERO to do with you.  I am just calling it out.  STOP making a mockery of the profession of Nursing.  Just STOP.

[Guest219794]

1 minute ago, CABGpatch_RN said:

Oh and remember, the last sustenance of your post, you said something like (paraphrased), and yes, I'm in a good mood today with a smiley face emoji?

I don't need you to be sorry for my feelings.  My feeling have ZERO to do with you.  I am just calling it out.  STOP making a mockery of the profession of Nursing.  Just STOP.

Have you seen the mileage her threads get?

Clearly a hit. Not likely to stop any time soon.

 

[SilverBells, BSN]

3 minutes ago, CABGpatch_RN said:

Oh and remember, the last sustenance of your post, you said something like (paraphrased), and yes, I'm in a good mood today with a smiley face emoji?

An what you write above is NOT how you worded that post.  YOU will NOT fool me.  Your manipulative ways need to be seen by everyone.  You are not a sweet innocent, my dear.

I don't need you to be sorry for my feelings.  My feeling have ZERO to do with you.  I am just calling it out.  STOP making a mockery of the profession of Nursing.  Just STOP.

That last part was only put just as an indication I felt as if I was thinking more clearly? No intention to be offensive 

[SilverBells, BSN]

I’m very sorry for anyone who thinks I should not be a nurse or that I am making fun of the profession. I do start threads that are unusual, but obviously in the wrong way, so really do strive to improve this. 

I do NOT expect anyone to believe me at this point.  I can tell you that anyone who personally knows me knows that I am a very strong advocate for patients and a great nurse to have around

[SilverBells, BSN]

With that said, I can verify that I'm not a terrible person.  There's many things that I do well, buf I'm obviously not perfect.  At the same time, normally I do okay with feedback that contradicts my post if only because that can be expected on the internet.  It never does feel good to upset others, though, and I feel bad.  Conversation, not uproar, is what I'm looking for.  Again, I'm sure many of you won't believe a word I said, which is your right. But I'm not an awful person or nurse

[JadedCPN, BSN, RN]

4 minutes ago, SilverBells said:

With that said, I can verify that I'm not a terrible person.  There's many things that I do well, buf I'm obviously not perfect.  At the same time, normally I do okay with feedback that contradicts my post if only because that can be expected on the internet.  It never does feel good to upset others, though, and I feel bad.  Conversation, not uproar, is what I'm looking for.  Again, I'm sure many of you won't believe a word I said, which is your right. But I'm not an awful person or nurse

Again I’m not sure why I’m indulging you but maybe it’s the wine talking. I can’t speak for everyone but I don’t think most think you’re an awful person, and I do think some of your posts have been interesting and started good conversations.
It’s when you throw in the Eeyore-style comments that many medical people view as someone who is depressed and borderline suicidal thoughts about not wanting to live, not being worthy of being happy or it being a waste to have any medical intervention done because you’d be happier with “eternal peace,” that any validity your previous comments may have had go out the window because it indicates that you are in fact depressed/suicidal, which is extremely serious, or you are a masterful troll manipulator who just posts those things for reactions. That’s where the issue is. I won’t say anymore on the matter because I feel I’ve wasted enough time being serious with you and I’ve come to my own conclusion many, many, many threads ago that you are purposely saying those types of things simply to get reactions out of people, which you’re very good at.

[Surfin USA]

23 hours ago, JadedCPN said:

Gillyboo if you follow the thread you’ll see that comment was in response to SilverBells essentially saying that they would decline ANY surgery in ANY scenario because they don’t see the purpose of them being alive and don’t believe they’re worth saving (a recurrent theme that SilverBells has posted throughout many threads). The 5150 also piggybacked on what I said which was basically there is a huge difference between being in the right mind to consent to a DNR which I fully support, and a healthy 20-something year old saying they would decline having an appendectomy because they are potentially in a bad mental space to make that decision.

Thats not exactly what she said. She said she would decline surgery in a specific case that was outlined for her. 

Something to do with female abdominal pain, and the asker was assuming she would agree to basically having exploratory surgery, just in case.

Look, not everyone is going to want every type of treatment. Shoot. Havent you ever seen someone who had abdominal pains or a bad cough go for months, not getting care? Thats all shes saying.

This is NOT about her having a death wish. It's about her recognizing that dying is a natural part of life. 

Look, yall don't seem to accept this small truth, but here it comes!!

Despite all the heroics, all the surgeries, and interventions, people do die. 

Even with hundreds of thousands of dollars in cancer treatments, people still die, often as a result of complications due to getting those treatments, and it doesnt necessarily even help to extend their life, much less improve their quality of life. 

Whats upsetting here is that you KNOW she has tachycardia. Yall KNOW (or you should know) that can be a chronic condition and often times, is a deadly one. 

So you have a patient with tachycardia that doesnt want to get surgery done, that doesnt want to get treated for any other conditions that might roll on up, AND doesnt like having tachycardia, to the point, that she wants a DNR/DNI as well.

Yet many are abusing this patient, for her CHOICES in not wanting treatment. Why? What gives anyone in here the RIGHT to be so degrading to her about refusing care? 

She knows that when it is HER time to pass, she just doesnt want a bunch of bells and whistles and tubes and devices and incisions and pokes, and drugs, in her system. She just wants her time to go, to be respected. 

Cancer patients that refuse chemo and or surgery don't get slapped with a suicide watch. It's DEGRADING. It's ABUSIVE.

And frankly, its not now, now ever, YOUR decision to make, for her, or any other patient. 

The reason this thread has come to this point, is because so many of you are being abusive and bullying a patient that you (1) disagree with her having a DNRO and also refuse to respect said DNRO, AND (2) This leads us to consider that perhaps yall may be sticking people who don't want to be stuck, that you may be force feeding someone who just isn't wanting to eat, or that you may be performing other procedures on someone who is also alert and oriented, and has clearly declared their rights, as a refusal. 

The sad part is.. and where psych and ethics need to come in- is that none of YOU are the slightest bit recognizant of your own narcissistic bullying tactics. 

If a 20 year old has appendicitis and is alert and oriented, and wants to keep their bad organ in death, THEY HAVE THAT RIGHT TO REFUSE. 

YOU don't HAVE THE RIGHT TO MAKE HEALTH CARE DECISIONS FOR OTHER PEOPLE. NEVER EVER. 

 

 

[Surfin USA]

 

10 hours ago, CABGpatch_RN said:

Oh and remember, the last sustenance of your post, you said something like (paraphrased), and yes, I'm in a good mood today with a smiley face emoji?

An what you write above is NOT how you worded that post.  YOU will NOT fool me.  Your manipulative ways need to be seen by everyone.  You are not a sweet innocent, my dear.

I don't need you to be sorry for my feelings.  My feeling have ZERO to do with you.  I am just calling it out.  STOP making a mockery of the profession of Nursing.  Just STOP.

You are being nothing more than a bully and a mean person. 

See unlike you unkind people, I do get an email digest. 

I found SilverBells post to be articulate, caring, and again, an in depth analysis of all the reasons a person can reasonably refuse treatment. 

 

Deleted attachments and posted new comment below. 

 

[Surfin USA]

Actually the post was here.. my apologies. I posted the wrong screenshots earlier. Silverbells I hope you understand that these nurses are being bullies and jerks and they do not have the right to do this. Do forgive me. I know you wanted to keep this deleted. I cant imagine why, is all. It's a great post. 

I will have to delete the last post. don't yall start calling me a manipulator or whatever like the rest of you damn bullies are boing with SB. Get a grip. 

 

 

[Davey Do]

11 hours ago, CABGpatch_RN said:

 

@Silverbells. You lady/mister are a master manipulator.   

This crap isn't funny. 

BING! We have a winner!

 But this crap is entertaining.

See how many sensationalism-seeking satisfied readers we have?