Warning-DNR forms are worthless

Nurses General Nursing

Published

I took care of my mother who had alzheimer's disease for the past 7 years. Everytime she was admitted to the hospital the very 1st thing I would do is to give them the POLST form that clearly said no CPR. However, it appears that the doctor didn't write an order for DNR. Thank God, I was physically present when she suddenly died. They called a "Code Blue" on her!!! :bugeyes:I was shocked. I told them "No,no she is not to be coded." So beware my friends, make sure if your loved one is a DNR to make absolutely sure that the doctor writes a "No CPR" order each and every time they are admitted to the hospital.

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I'm sorry to hear of your mothers death, that must be very hard for you even though you've probably been saying good bye for a long time now.

I've noticed every time we get a re-admit, we still have to get new code paperwork, even though I would consider the person to be a no code without it.

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Specializes in Med/Surg.

One facilities DNR is worthless at anothers, same with the Florida DNR that you use at home for EMS, it's worthless in the hospital setting. The Dr. must sign the hospitals DNR to be official.

Legalities.

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Specializes in ED.

Hospital policy in our facility is that we need a signed medical order for DNR. The DNR that comes with the patient from the nursing home is not good enough.

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Specializes in ICU.

yeah, I make sure to stress this to our families of new admits. I work in an LTAC ICU and a lot of our folks will have or be considering DNR. IF they have one already, we must write an order and have them fill out our paperwork. This happens more in our med/surg floor. Our ICU unit has less DNR patients. A lot of them are futile care, it's sad. Where a DNR was meant for patients just like these, the families are against it.

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Specializes in Hospital, med-surg, hospice.

People don't understand DNR orders and think they mean "do not provide care", I have seen families overturn a patients wishes and doctors afraid to challege the patient children. Its all very sad :nono:

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But haven't some states passed laws that make they much more binding?

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Specializes in ICU, Telemetry.

And it can vary, even inside a state. The hospital I work at requires a signed MD's order, regardless of all the state DNR forms you may wave. The site I do clinicals at just requires the state form and DOESN'T require the order.

God only knows how many folks who wanted to be DNRs have been brought back.....Go read my article called "The Patient I Failed."

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Specializes in all kinds- intensive care my most.

I have been a nurse for 15 years, I have worked in 5 hospitals. All of them require a written DNR order on the chart upon admission even with living will or home DNR papers.

Why? Because the hospitals have been sued many times by family members who decide that mama shouldnt be a DNR. Now that Mama cant speak for herself, the kids decide to speak for her. So why even bother?

Thats why everyone needs a Healthcare Power of Attorney. This person can make all your decisions for you without interference from anyone else even your children/spouse.

I am 35, my daughter is 17. She already knows what i do and do not want regarding end of life. She will make the decisions.

Moral of the story- find you a POA, tell them what you want. POA papers are more binding than DNR papers.

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Specializes in Management, Emergency, Psych, Med Surg.

Sounds like the doctor was not paying attention. At our hospital, if the POLST form is on the chart, that is what we follow, doctors order or not.

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Specializes in LTC, assisted living, med-surg, psych.

That's pretty scary stuff. When I send out a resident to the hospital from my nursing home, I always send a copy of the POLST with them. Guess I figured it was actually worth the extra 15 seconds to make the copy.

I also keep copies of my own signed POLST form handy at home on the refrigerator, just in case.........that's why I HAVE a DNR order, I don't want anyone messing with me and trying to bring me back if I've gone on to greener pastures. It definitely doesn't mean "don't take care of me" or "don't try to fix me if I've got something that can be treated", but I swear, if I'm ever given CPR I'm going to haunt the code team for the rest of their days........grrrrrrrrrrrr..........

Shame on doctors and nurses who allow the fear of incurring a lawsuit or the wrath of some family member to interfere with what we know the patient wants!

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Specializes in Cardiac Telemetry, ED.

At my facility, the doctor must write a DNR order for the patient to be a DNR, POLST or no POLST. The POLST is for care outside the hospital. While in the hospital, code status is an MD order for the duration of that hospital stay. Of course, the code status can be modified per the wishes of the patient or their MPOA, but the MD must be the one to write the code status as an order.

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