Quote from nhelkhound
The problem that I have with full codes is that the patients that I've had during NSG school are listed as full codes but when you communicate with them they don't REALLy want to be but have given in to pressure from either their family or their doctor. I have spoken to some who have told me that they didn't know they had a choice!
BTW, it seems absolutely bizarre to me to have a patient on hospice without a DNR. To claim Medicare hospice benefit means that the patient only wants palliative care, not life-prolonging measures.
Actually, one only needs to have a six month prognosis in order to be eligible for hospice services from the Medicare perspective. Hospices often put conditions on admitting that include no chemo, no radiation, no transfusions, no vents, no dialysis, etc. but this is more a financial issue than anything else. Some hospices with Open Access programs put NO restrictions other than the six month prognosis on their patients and will provide all the above therapies and more. And in point of fact, a hospice can NOT require that a patient be a DNR in order to admit; it's in the regs.
I can understand that you don't like med/surg for a variety of reasons, but coming in to hospice with the perspective that every patient only wants and should get palliative care is a one size fits all approach that really doesn't.
There are MANY factors to considered around the issue of code status. If you believe as a nurse that your patient's desires are not represented in their code status, advocating for a discussion with the physician will be doing a terrific service for your patients.