I, too, have had many patients who I felt should have been DNR, but were not. however, that is not our decision to make. The decision to change code status is not an easy one. It is one thing to say what others should have done. It is another when we, ourselves are faced with the same decision. We cannot see into the hearts and minds of the families of these patients. We do not know the reason these precious souls are still with us. Our job is to give those patients the best care we can, keeping them as healthy, comfortable, and secure as possible, and to support and respect those who have entrusted us with their care.
For example, we had a patient who had multiple cardiac and respiratory problems. Before coming to us, she had been resusitated multiple times, and had been on mechanical ventilation more than once. She was a full code, at her request, and with her family's support. during the nearly 3 years she was with us, we sent her out in near-code condition 12 times, and coded her once. Each time, she recovered, and returned "home" to us. Because of the care we gave to her, she and her family were able to share 3 years she would not have had, had she been a DNR.
We will always have patients who will break our hearts, who we will grieve over because of their suffering and lack of quality of life, as we know it. But we continue to do our best to care for them, because we are nurses. That's what we do. That's who we are.
If you are against the use of feeding tubes, etc to prolong life, make out a living will, and let your family know how you feel. Otherwise, one day, you may be the patient with the GT and IV's, simply because of a decision your loved ones cannot bring themselves to make.
