DNR & the KBN....Laws

[crb613, BSN, RN]

Does anyone know where I can read all the regs about DNR's??? I was told it is up to the nurse to see that a DNR is revoked before surgery...then reinstated after the procedure. This does not seem right to me. I would appreciate any help on this, where I can read the laws ect. I looked on the KBN but I could not find anything on this. I may not be looking in the right place. Thanks!

[caroladybelle, BSN, RN]

I don't know about Kentucky. But as we can neither write nor DC orders, that would be highly irregular and quite difficult to enforce.

Technically, I believe that it is the surgeon/anesthesia's duty to notify the patient/family whether the DNR will be voided during surgery and the implications of that as they should be writing the order (or enacting it if it is a facility protocol). And the order should be reinstated by the MD in charge of the admission, though sometimes the surgeon will reinstate it.

Obviously, many of them "forget" and as such, we may have to remind them (repeatedly!!!!). There is also that problem, when they are several MDs caring for the patient, that they try to dump this duty on each other. As patient advocates, we should apply the appropriate pressure that things are done per the patient's wishes. But I believe that the actual duty belongs to the MDs as previously mentioned, because we do not have the legal capacity to write orders nor do we have the ability to force the issue, other than by making an ethics complaint/contacting the Head of Medicine for the facility.