DNR issue

[micstn]

I was told by social worker to remove DNR for a patient because POA said he never told me to place pt on DNR. But actually POA did tell me this by phone, I relayed to dr who ordered DNR/TO. Now next day social worker talked to me and looked at me like I'm a liar. What I could do is i immediately switch patient back to full code and notify Dr. Would this cause any warning or even write up, I think I didn't have a witness with me, POA could take back his words, it makes sense for such an serious document. Thanks for any input and appreciate for any advice. I won't touch any paper DNR related, so complicated, in future I will wait for social worker to deal with it.

[MunoRN, RN]

Resuscitation is a medical intervention that isn't really up to the social worker or nurse to be independently in charge of, the MD needs to clarify if resuscitation is an option that should be provided to the POA or patient and then have a discussion with them.

[micstn]

It is a gray area in our hospital, sometimes we admited a patient, dr just ordered DNR by phone, no paper, just claimed patient is DNR

[MunoRN, RN]

It is a gray area in our hospital, sometimes we admited a patient, dr just ordered DNR by phone, no paper, just claimed patient is DNR

The bigger issue besides who's actually entering an order is that it was a social worker who was asking you to change an order for medical treatment. For instance, if a cardiac surgeon declines to offer a patient open heart surgery, would it be appropriate for a social worker to override them and schedule the patient for the OR?

Ideally MDs enter all their own orders, particularly code status. It's up to the Doc to enter code status, but it's also the nurse's responsibility to ensure that the entire plan of care is accurate, which may at times require entering this as a verbal, ideally when the MD has stated the code status elsewhere in the chart, such as the H&P or note.

[micstn]

Great insight, why I didn't think this way. Thank you very much!

[NuGuyNurse2b]

Document, document, document! Also, at our facility, a DNR order cannot be done verbally or via telephone. The MD simply must enter the order himself. It prevents situations such as this.