DNR and Assisted Living Facilities

[mdiada]

Hey, all! Hope everyone is doing well!

I have a bit of a complicated question. I work as a Resident Assistant at an ALF in the state of Kentucky. From the get go, we were told we, by law, are not to perform CPR due to the type of building it is. Well, my question concerns something that happened at work involving a choking man and his having a DNR. Let me just say that my boss does not, nor has she EVER explained anything well at all. She scolded us for wanting to help this man who was having problems breathing and was choking, saying that because of his DNR, we are not allowed to do such a thing, and we would be sued for it. My boss is not a nurse, nor does she have any medical training as such. But she is my boss.

Well, I always thought a DNR concerned already unconscious people, not people who are fully alert and choking. I have no qualms at all honoring a person's DNR if that is their wish.

But does it make sense to not be allowed to assist in dislodging the item in order to prevent unconsciousness? And also, would we not be held liable for NOT performing the Heimlich and simply stood by and allowed that person to die?

I am thoroughly curious and would love any helpful answers at all. Thank you!

[mrsboots87]

Someone correct me if I am wrong, but I believe you are actually correct in this instance and your boss needs some re education. DNR is not for people choking on food or drink. It is for people already passed out and not breathing. By withholding care and not attempting to help the resident dislodge whatever was choking them, this facility could actually get in trouble for neglect I believe. IF is Heimlich is unsuccessful and the resident stops breathing and goes unconscious then that is the time to withhold life saving measures. When I was in block 1 clinical, a man choked on some food. He started waving his arms and coughing hard. A nurse rushed over and did the Heimlich and got the food dislodged then off to the ER for the resident. When asking the nurse after why they didnt see if the resident was DNR, the nurse said he was but it didnt matter because you cant withhold care until they completely stop breathing. I would be incredibly upset if I was that resident. I my not want my ribs broken and my chest pounded on, but I do want some food dislodged.

[Asystole RN]

Choking is what happens before the resuscitation part. Choking will lead to the whole arrest thing but the body is definitely trying it's best to still breathe...hence the choking mechanism.