so, i ran to my first code alone last evening.... the adrenaline was flowing and i was feeling pretty good when i was the first one there after the resident and i started cpr, was pushing epi and atropine, and really participating. we intubated, drew a femoral abg, etc... and then it happened...
[color=#483d8b]the other icu nurse recognized the patient and said 'he was a dnr on our floor.' she checked the chart and sure enough the man was a full dnr.
[color=#483d8b]i feel pretty guilty/angry today. guilty for not checking myself and putting the poor man through all of that.
[color=#483d8b]angry that there was a huge communication breakdown in the system so that the bedside nurse's kardex said this man was a full code when the code sheet in the chart said exactly the opposite! :angryfire
[color=#483d8b]how do the rest of you identify pt's who are dnr? i think our system needs an overhaul and i'm in the mood to take action. i don't want to ever feel this way again!
there is a DNR order in the computer (online cart), the nurse assigned SHOULD KNOW, color coded stickers on pts paper chart, and bright blue bracelet on pt's wrist.
Specializes in Oncology/Haematology/Stem Cell Transplant, Med/Sur.
this is how we knew at my old facility;
there is a DNR order in the computer (online cart), the nurse assigned SHOULD KNOW, color coded stickers on pts paper chart, and bright blue bracelet on pt's wrist.
I am little confused with a DNR and repeating that each handover, I do but shouldn't it be charted by the Doctors every 24hours for that order to stay current? By the way DNR in the USA = NFR in Australia.
The mention of colour codes - like bracelets great idea, we have stickers on medical charts but the choice of colour I think should be universal? What do others think?
Purple arm band at my hospital means - chemotherapy precautions for Oncology patients, and if I see purple or blue gloves in the bin - I think chemo too.
At the hospital in my town, we put magnet signs on the frame of the pt's door. There are ones for DNR, NPO, FSBS, the main stuff really..But I really think the bright yellow wristband is a very very very good idea. That way, it's right there on the pt
We do an arm band, put a red dot by the pt's room on the board, and before I take over a pt, I put an eyeball on the doc's DNR order. No time to do that if you're on a code team or hear someone scream for help and run into the middle of one.
Keep in mind, you can stop a code. You don't want to find out 10 minutes after your "DNR" stopped breathing that they were a full code...that's been one of my biggest fears....
so, i ran to my first code alone last evening.... the adrenaline was flowing and i was feeling pretty good when i was the first one there after the resident and i started cpr, was pushing epi and atropine, and really participating. we intubated, drew a femoral abg, etc... and then it happened...
[color=#483d8b]the other icu nurse recognized the patient and said 'he was a dnr on our floor.' she checked the chart and sure enough the man was a full dnr.
[color=#483d8b]i feel pretty guilty/angry today. guilty for not checking myself and putting the poor man through all of that.
[color=#483d8b]angry that there was a huge communication breakdown in the system so that the bedside nurse's kardex said this man was a full code when the code sheet in the chart said exactly the opposite! :angryfire
[color=#483d8b]how do the rest of you identify pt's who are dnr? i think our system needs an overhaul and i'm in the mood to take action. i don't want to ever feel this way again!
[color=#483d8b]thanks for listening! :heartbeat
at the ltc where i work, they have stickers on the door...i'm thinking this could be done with id bracelets as well. red stickers mean stop/dnr and green stickers mean go/full code.
i didn't read all the responses so if someone else already said this, please accept my apologies.
Aren't they moving towards universal colors for armbands in the US? I know we just had to change our armband colors to get in line with some new initiative from somewhere. We used to use blue for DNR and orange for fall risk, now they are purple and yellow respectively. Red for allergies. Add in the blood bands and isolation bands, and it's possible for a patient to have five different bands on.
Specializes in Mostly: Occup Health; ER; Informatics.
Aren't they moving towards universal colors for armbands in the US? I know we just had to change our armband colors to get in line with some new initiative from somewhere. We used to use blue for DNR and orange for fall risk, now they are purple and yellow respectively. Red for allergies. Add in the blood bands and isolation bands, and it's possible for a patient to have five different bands on.
so, i ran to my first code alone last evening.... the adrenaline was flowing and i was feeling pretty good when i was the first one there after the resident and i started cpr, was pushing epi and atropine, and really participating. we intubated, drew a femoral abg, etc... and then it happened...
madwife2002, BSN, RN
26 Articles; 4,777 Posts
We use a purple armband, it works well