Fickle DNR question

So my worst nightmare happened to me today. And this is long. I had a 70 year old man with end stage COPD. He was barrel chested, anxious, had substernal retractions. He was cachectic. He was satting well (89-92%) on 3L nasal cannula. He was a DNR. He had recently been intubated and on the med surg floor after a successful extubation. He had to be tubed when his wife found him unresponsive. He also had MRSA pneumonia and he said this was the the 10th time this year he'd had it. He was alert and oriented and when I was taking to him I realized he didn't know what a DNR meant. I explained it to him. He said he didn't want it and wanted to be intubated if something bad were to happen (again). I said ok. Called the doc and told her and made him a full code. Mind you he had already signed up for hospice.

So later on the NP and wife come in. I let the NP know he's rescinded the DNR. The wife freaked out. She said "honey we talked about this, you're end stage, I can't keep going through this" the NP re-explained his condition to him, how intubating him was futile and wouldn't cure his condition but only prolong the inevitable. He agreed to be a DNR once again. His wife also basically told him she would make him a DNR anyways once he was unconscious again, so he really didn't have a choice. He also said he would feel bad if she had to make the decision to stop life support. The DNR is signed everyone seems to be on the same page and happy. We're waiting for hospice to come evaluate him.

About an an hour later he is eating and has a panic attack because he feels short of breath. His sats are low (82%) and he keeps saying "I need air". I bump him up 1 L and ask him to take deep breaths and stop eating and catch his breath. He does, sats come up (98%), I bump him back down. Another hour later (with wife still at bedside) he starts panicking again, he said he needs more air. I check him again, he's satting well but tachypneic and we get him to calm down. He ask for something for anxiety. I offer him either Ativan 1 mg IV or morphine. He and the wife opt for Ativan. So I give it. He was talking to his wife about an hour later and became tired, so she left.

2 hours later I check him and he's still sleeping. He's also not rousable. However his vitals are perfect. He was actually satting 99% on two Liters. I try everything I know how to wake him up. He's not waking up but again vitals couldn't be better. I check sugar & it's 168. Call the doc and let her know. Also hospice comes in and I ask if he would qualify for the hospice house (inpatient hospice) and she says yes she can get him in tonight. She calls the wife and lets her know. Doc signs DC orders and the wife comes in as were arranging transport. Then the wife sees him and loses her mind. She says this isn't him and he needs to come back to her. She blames me and asks me what I gave him. I show her the MAR. The only thing he had all day was one mg IV Ativan while she was present. She says Ativan isn't good for him and not to give anymore (of course). By this time it's been seven hours since I gave it. I explain it doesn't last this long IV normally but he is probably having trouble clearing it from his system since he is so chronically ill. She wants a reversal agent and asks if it will wear off and he'll be back to normal. Mind you he had just been extubated in ICU 2 days prior. This is the same woman who wanted the DNR. The same women who discussed hospice today. Who told him this was the end. The same woman who requested I give the Ativan earlier. The one who was aware he was going to the hospice house that night. She didn't rescind the DNR but this was the end of my shift. I gave report and left. I wrote a long note about the days events. I'm still getting whiplash from the change of hearts between the two of them. She seemed so sure it was his time just that morning. What happened? Did I do something wrong? I had him hooked up to continuous vitals all day. Checked on him frequently and did what they asked to keep him comfortable but stable. He still had perfect vitals when I left. I used to work a hospice floor and have never had someone so sure of what they wanted change their mind like this before. Im actually kind of scared to have another DNR COPD patient again...ill certainly be very wary of giving Ativan to anyone for a while.