This wasn't my patient, but last week on my med/surg floor a LOL who happened to be a DNR suddenly developed an irregular very fast heartrate and became less responsive. It was early in the shift, and because the patient's heart rate went from a baseline SR in the 70's to irregular in the 140's/150's, the nurse called a rapid response on the patient so an ICU nurse came over and evaluated, a stat 12 lead EKG was ordered,etc. Just standard. I was half paying attention to this while assessing my own patients just to see if the nurse needed any help with the rest of her assignment.
Anyway, when the attending physician arrived to do his rounds, he was *#$$&%. Stood at the nurse's station loudly complaining "Why was a RR called? She's a DNR!!" and was curt to the nurse and yelled to "just consult hospice" and "don't do anything" and told the ICU nurse to leave.
Now, to me, a DNR order is not akin to a "comfort measures only" order. I mean, if the lady coded we would not have tried to resuscitate, but she wasn't coding, only showing new cardiac symptoms.
The nurse was upset and thinking she did something wrong. I told her that she did the right thing for the patient.
What is your opinions? I know that there are a lot of details missing here, but just the general question of do you call a RR on a DNR patient?
