DNR question

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Specializes in ER.

I was reading another thread dealing with DNR orders that reminded me of something we recently discussed in clinical. It disturbed me quite a bit, and I thought that some of you with experience could give me some input on the subject.

Our instructor brought up the fact that even when patients have a DNR order, if the family members insist on resusitating the patient, then we have to do what we can to save them. HUH?! Her rationale was that the family are the ones left to sue you when the patient dies. My thought was, "O.K. ..Sue me! If some terminally ill client who is suffering has a DNR order so they can die on their own terms and with with dignity, I'm not going to touch them."

As I said earlier, I found this VERY disturbing. Is this actually a common philosophy that is put into practice, or did I just run into a nurse who feels this way PERSONALLY and is presenting it as a standard practice? Also, would there not be legal ramifications for resusitating, or attempting to resusitate, someone you KNOW has a DNR order?

Thanks.

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Specializes in ER.

"My thought was, "O.K. ..Sue me! If some terminally ill client who is suffering has a DNR order so they can die on their own terms and with with dignity, I'm not going to touch them."

I agree with you in theory, but unfortunately, the real world rarely crosses reality! I am not sure just what the legal ramifications might be, but I have seen quite a few "DNR" patients recussitated over the years. Living wills are just requests, while an actual order is stronger, but I still think next of kin, especially if they have been given power of attorney for healthcare, can have the DNR recinded at any time. When working in ICU several years ago, they brought us a young woman (30's) who had arrested after a long bout with breast cancer, had a living will and DNR, but when she started having acute shortness of breath "near the end", her husband could not handle it, demanded she be intubated, IV, etc. By the time she got to us, she was alert but intubated and MAD AS HELL at her husband. We extubated her shortly afterward, and she was very upset with her husband. It was very sad. We do not live in a perfect world, suffering goes on, and unfortunately we don't always have the autonomy we would like to choose to live or die. Good luck in your future nursing practice. It is not always a pretty world we live in.

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That's disgusting. As long as the patient has a DNR on the chart that is in order, they are a DNR no matter what the family says. If the family has decision making authority, then that's another matter. I have never heard of anyone being sued for respecting a DNR.

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That's disgusting. As long as the patient has a DNR on the chart that is in order, they are a DNR no matter what the family says. If the family has decision making authority, then that's another matter. I have never heard of anyone being sued for respecting a DNR.

Fergus - I'm pretty sure you are also from Ontario. I WISH that a DNR could be honoured and respected but it isn't written in stone. A DNR by itself does not guarantee anything. When a client is incapable of decision making (they are coding after all), the next of kin has the say and if they say resuscitate, we HAVE to resuscitate. The doctors in the hospital that I work in have a family meeting when a client decides on a DNR and he/she speaks with all about the importance of the DNR and the fact that it is the patient's wishes.

Whenever anyone asks me about DNR's, I tell them to protect themselves further by inacting a power-of-attorney with regards to medical directives. I also tell them to make sure that they chose someone who will follow through with the patient's wishes rather than their own emotions at losing the loved one. I was my father's POA for medical decisions because he knew that my mother would not be able to deal with it emotionally. I know it sounds awful, but when the time comes, a person needs to be sure that the one they chose is capable of "pulling the plug" and able to live with that decision.

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Your instructor sounds stupid. Ask her if it ever occurred to her that the patient who was coded against his/her will and survives can also sue you.

Ask her if she realizes that a visitor who insists that you stop CPR on a coding patient to get another patient a glass of water can also sue you.

Anybody can sue you for anything. Doesn't mean that they actually are right or have a good case.

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