DNR does not mean do not treat, people!

[rnto?]

I just wanted to vent. I've heard several people say, over the past few days, "Well, they're a DNR so why are we doing XYZ?" Um, because if their heart stops they don't want CPR, but the last time I checked treating Afib with coumadin was not CPR? Most recently I was giving report to the oncoming supervisor, and was telling her about a LTC patient who was being worked up for ca. She asked if the patient was a DNR, which she is, and then asked why we were doing a ca workup on a DNR patient-"they don't do chemo on DNRs" Oh really? This nurse was new to our facility-she's an ICU nurse who acted like LTC/SubAcute was beneath her and that she knew everything there was to know about geriatrics because "people in the hospital are old". (her words)

[ltcatheart]

I have heard the same statement, "they are DNR anyway". Makes you want to go hmmmmm! I agree with the definition above on Hospice and the other. I think some nurses (in the working environment) need to keep their opinion of DNR to themselves. If they go in cardiac arrest, then that comes in to play, no CPR!

[JenniferSews]

noyesno, the food and fluid recommendations for actively dying patients is this; they get what they want.

I tell my hospice patients, families and docs this exactly. "They get what they want." But I have rehab hip replacement patients who are DNR who still have viable months or years of their lives left. DNR, hospice, and palliative care have VERY different meanings.

[PatricksRNMommy]

I can't stand that! There are quite a few doctors at my facility who get the attitude of "Why are you calling me, they are a DNR" if we call with concerns about a patient. And if you try transferring a DNR patient to the ICU, you definitely hear it from some of the ICU nurses as well. I have had many disagreements with nursing supervisors not wanting to "give up a unit bed for a DNR." DNR patients can still get aggressive treatment and ICU care, we're just not going to do CPR if their heart stops or intubate them if they stop breathing... Glad to find some others who feel the same...

[KarmaWiseRaven]

I hold a DNR Its posted at my Dr's office and my local hospital with my advance directives. I have a medical alert necklace that says my allergy's and my DNR.That does not mean to starve me or keep drinks from me. It means if my heart stops don't try to save me. If i stroke out and can not return to normal like I am right now let me go. Don't do anything special to prolong my life.

I'm reading this posting and i can not believe how many nurses misunderstand a DNR. Now if I'm having a allergic reaction to something or a break my arm or leg or i get in to a wreck Save me ok. Only if i am having a heart attack and go in to code let me go through it and don't do anything. ( If this is off topic I'm sorry) These are my thoughts use them as you wish

[vampcna]

I work at an ltc and we have quite a few dnrs and hospice patients. I am a

cna (I hope to be in an lvn program by winter), so I will admit that my medical

knowledge is somewhat basic. That being said, I have learned how to tell if a

patient is at death's door. When I tell a certain lvn " patient x is having trouble

breathing and isn't responsive" why does she respond by shrugging and

saying," That's ok. She's hospice anyway". I didn't think hospice meant let

them die suffering,scared and alone. This really upsets me and I will usually

stay with my dying patient, giving what little comfort I can. When I voiced

my concern about this to a coworker I was told " What do you expect the nurse

to do? She can't waste her time with a hospice patient when she has other

patients who aren't hospice she needs to provide care to".

Another thing that drives me nuts is seasoned nurses and cnas who

say things like" well I hope they die soon because they're too hard and time:madface:

consuming to care for":crying2:. My God, where is the compassion?

[Hospice Nurse LPN, BSN, RN]

I work at an ltc and we have quite a few dnrs and hospice patients. I am a

cna (I hope to be in an lvn program by winter), so I will admit that my medical

knowledge is somewhat basic. That being said, I have learned how to tell if a

patient is at death's door. When I tell a certain lvn " patient x is having trouble

breathing and isn't responsive" why does she respond by shrugging and

saying," That's ok. She's hospice anyway". I didn't think hospice meant let

them die suffering,scared and alone. This really upsets me and I will usually

stay with my dying patient, giving what little comfort I can. When I voiced

my concern about this to a coworker I was told " What do you expect the nurse

to do? She can't waste her time with a hospice patient when she has other

patients who aren't hospice she needs to provide care to".

Another thing that drives me nuts is seasoned nurses and cnas who

say things like" well I hope they die soon because they're too hard and time:madface:

consuming to care for":crying2:. My God, where is the compassion?

:tku:

Some nurses just don't "get it" Hospice is comfort care. They (should) have meds on board for pain and symptom mgmt. There are dying folks in LTC who have no family to see about them. They die alone and this is so sad. Thank you for spending time w/ these pts. You will be a wonderful nurse!

[akulahawkRN, ADN, RN, EMT-P]

I work at an ltc and we have quite a few dnrs and hospice patients. I am a

cna (I hope to be in an lvn program by winter), so I will admit that my medical

knowledge is somewhat basic. That being said, I have learned how to tell if a

patient is at death's door. When I tell a certain lvn " patient x is having trouble

breathing and isn't responsive" why does she respond by shrugging and

saying," That's ok. She's hospice anyway". I didn't think hospice meant let

them die suffering,scared and alone. This really upsets me and I will usually

stay with my dying patient, giving what little comfort I can. When I voiced

my concern about this to a coworker I was told " What do you expect the nurse

to do? She can't waste her time with a hospice patient when she has other

patients who aren't hospice she needs to provide care to".

Another thing that drives me nuts is seasoned nurses and cnas who

say things like" well I hope they die soon because they're too hard and time:madface:

consuming to care for":crying2:. My God, where is the compassion?

That can be part of the normal dying process. The problem is that some people don't take the time to check and assess the patient to see if this is something that can be relieved by medication that's not contraindicated by the specifics of the DNR. It could very well be that something simple relieves the trouble and makes the patient more comfortable.

I don't agree with the attitude... but some people do have it, and I've seen it in other fields as well.

Good example: a Hospice/DNR patient having chest pain of a cardiac origin. I won't give NTG to that patient because NTG is a vasoactive drug. I will, however, want to give morphine or perhaps fentanyl (whatever the orders allow for) for the primary purpose of relieving pain and anxiety. That, IMO, is consistent with a DNR...