Do not resuscitate conflicts within the family.

[WonderingMind]

what happens when a doctor refuses to write a "dnr-do not resuscitate" order? say the patient and his family members disagree on the patient's right to refuse resuscitation. the wife wants you to do everything and the patient's doctor refuses to write a dnr - what do you as the nurse do when the patient goes into cardiopulmonary arrest? do you follow the patient's wishes or do you resuscitate anyways? where can i find more information on this topic?

[ShayRN]

In our hospital, as long as the patient is competant to express their wishes, we can make them a DNR without a doctor's order. We also have a policy in place that the doctor has to discuss the conflict with the patient and if he still won't sign the DNR, he MUST turn the care over to another doctor who will. If they are confused and have nothing in writing, we follow the wishes of the family.

[suebird3]

what does the patient want? or does the wife have hcpoa? (power of attorney) i s there a living will?

suebird

[WonderingMind]

there isn't a living will and the couple has counseling but yeah it is ultimately the husband's decision. there isn't a thing in writing but we know that the patient doesn't want to be resuscitated. but i guess the best thing to do is suggest to the patient that he turn his care over to someone who will write a dnr i think that will be best for everyone involved.

[rosemadder]

that and do a slooooooooooooow code...

[leslie :-D]

in the meantime, i would document the pt's stated wishes in the nurse's notes; and also note md's refusal and any other pertinent data.

[clee1]

A tough problem....

A pt has the absolute right to determine the limits of the care that they receive, as long as they are still mentally capable of making that decision.

HOWEVER, if the family member wants a code and one isn't done; you, and the facility, WILL be sued. Count on it.

Personally speaking, I'll advocate for and follow the wishes of a mentally competent pt. The facility may not appreciate that, though. Also, it will help matters temendously if you make yourself as "judgement proof" as possible and ALWAYS carry your own malpractice insurance.

[elkpark]

This is why hospitals have ethics committees. Get yours involved.