DNR question

Nurses General Nursing

Published

I have a question about a DNR scenario. Let's say a family (the wife, for example) made her husband a DNR. So the time finally comes, and the husband stops breathing. The wife goes into total distress and says "I change my mind! Do something!"...... are we supposed to do something?? Does the piece of paper with the code status triumph any family pleas?

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Specializes in Trauma ICU, Surgical ICU, Medical ICU.

Should it? I personally think not. However, many of our patients (high acuity MICU) are 'DNRs'. No one will take on that liability, plus if you dont have the paperwork, you get recussitated anyway, if someone is at home they will most likely be recussitated. I think it should be about the patient first and foremost and if the patient has made that decision it should be honored. It hardly ever is, at least where I work, because no one wants sued. Also, we have even had many families 'reverse' DNR plans, only do half of the plans (we'll be a DNR but no pressors, or only 2 pressors, but intubation and CPR are fine! ***!!). Also, in order to have a DNR on our books there has to be a family meeting and the DNR has to be signed by 2 attending physicians. Usually the family already decides this because the patient is crashing and a code is iminent. So if someone is found down at home, or even on a reg. floor and paperwork isnt there or incomplete, they WILL code the patient, at least where I work.

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

DNR's can be revoked at any time by both patient and next of kin, including that final moment.

In that case I would gently remind her of the DNR that was agreed upon, that it's what the patient wanted, and ask if they are 100% sure they would to subject their loved one to futile CPR. Something like that. If they insist, then you must proceed with their wishes.

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Specializes in Geriatrics, pediatrics.

this doesn't actually answer your question, it's just some info that i found on the internet. i think policy varies by state and by facility what would happen in your scenario:

what happens if i change my mind after a dnr order has been written ?

you or anyone who consents to a dnr order for you can remove

the order by telling your doctor, nurses or others of the

decision.

what if i change my mind after my doctor writes a dnr order?

you always have the right to change your mind and request cpr. if you do change your mind, you should talk with your doctor right away about revoking your dnr order. you also should tell your family and caregivers about your decision, mark "cancelled" on the actual dnr order, and destroy any dnr wallet cards or other identification items you may have. if you have a dnr order, but change your mind about the level of care you would want regarding cpr and medical interventions that may prolong life, you will need a new order.

what if members of my family disagree ?

in a hospital or nursing home, your family can ask that the

disagreement be mediated. your doctor can request mediation

if he or she is aware of any disagreement among your family

members.

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Specializes in Physical Rehabilitation, med-surg.

I've been in that situation before, and it's my understanding that the DNR can be revoked at any time if that's what the patient or the person making decisions for them decides.

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