DNR/I pts with multiple tests

[galfromnairobi]

I i,m well aware that a dni/r status does not not mean do not treat,but my experience today left me questioning the validity of some tests. i had a pt with a diagnosis of lung CA with brain and prostate mets. he was transfused 2 units prbcs during night shift. at 8a.m he was off to nuclear med for a bone scan (r/o bone involvement). when he returned, he had to go to CT(spiral) r/o PE,coz one of his admission symptoms was sob.(was probably d/t low hct). after that he had to go for the 2nd part of his bone scan. he also had a rectal bleed before admission which had ceased. I was supposed to start preping him for a colonoscopy. he threw up the first cup of go-lightly. i had mentioned to the docs that he would not be able to tolerate the go-lytely. his anorexia was well documented not to mention the n/v. the docs wrote an order to give reglan and insert an ngt to adminster the go-lytely.the pt refused the ngt. the docs solution was to order bowel series. the pts sister is his power of attorney and she wants all diagnostic procedures done. the pt said he has relied on his sister's judgment and guidance for years so he generally goes along with his sister's suggestions. the pt is not currently receiving treatment for his existing CA, so what is the point of the additional tests?.one of the docs said that they had previously suggested to the pts sister to consider palliative measures only, but she refused. the pt is her younger brother,he is 61. it is a wonder that she made him a dnr/i. i felt sorry for the pt and all that he was going through.a significant part of my time was also spent putting him through what seemed like hell to me. has anyone else been in this type of situation and what was done?

[irshnrse]

That is why DNR/advance directives are not working. The key here is that the sister is selfishly going against her family member's wishes. That is why I tell people to make sure their power-of-attorney, or health care proxy, knows what they want and will be strong enough to follow through. How said for that poor gentleman. I will be thinking of him. I do not believe people should have to suffer like that.