Hospice, DNR's and POC's

[Tait, MSN, RN]

EDIT: Meant Health Care POA's not POC's lol. >.

I am curious now after Flightnurse2b's DNR dilemma thread...

Do Hospice patients have to have Advanced Directives and Living Wills? DNR's in place? How do these choices transfer to other facilities when the patient needs acute care?

Thanks for any responses,

Tait

[FLArn]

No, at least not in FL. We have patients at times who are not emotionally prepared to sign DNR's. They are aware that if their condition begins to decline and they chose to seek aggressive treatment they will be asked to revoke their hospice election and will be sent 911 to the hospital. However, the social worker, doctor and of course, we nurses keep trying to educate them on their condition, prognosis, and what their probable outcome of aggressive treatment might be. Most of the time within a few days to weeks they become ready and sign DNR's. We have our own free standing inpatient units for management of uncontrolled symptoms and death imminent and actively dying patients so most of our patients come to the IPU's and avoid the scenarios of hospital stays with the types of problems Flightnurse2b experienced.